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目的了解本地区老年人跌倒在老年人院前急救中所占比例及跌倒后受伤情况,探讨老年人常见病与跌倒之间的关系及社区宣教在降低老年人跌倒致创伤方面的作用。方法采用回顾性对照研究的方法,研究对象为2013年1月—2014年12月南昌市青云谱区内所有因跌倒相关问题呼救“120”的老年人,按时间段将其分为2组,对照组:2013年1月1日—12月31日;实验组:2014年1月1日—12月31日,2014年在青云谱区所辖50个社区进行了老年人跌倒危险因素及跌倒后救护相关知识的宣教,收集2组跌倒老年人院前急救病例,并对其在医院内检查、诊断、住院、手术情况继续进行追踪。结果 2014年与2013年相比,青云谱区老年人增加了0.64%,呼救“120”的老年人增加了8.45%,然而经过社区宣教,因跌倒相关问题呼救“120”的老年人减少了14.75%;2组呼救“120”时间对比,差异有统计学意义(χ~2=10.444,P=0.034),老年人跌倒至呼救“120”的时间明显提前;2组创伤人数对比,差异有统计学意义(χ~2=6.162,P=0.046),社区宣教后跌倒致颅脑伤及骨折人数显著减少,但扭伤及肌肉拉伤有所增加;2组患病情况对比,差异无统计学意义(χ~2=11.15,P=0.266),社区宣教不能改变跌倒老年人所患基础病种类;但某些疾病与跌倒关系密切。结论社区宣教可以降低跌倒致创伤率,尽早的专业救护和治疗可以减少不必要的二次损伤及合并症的发生。跌倒老年人患多有心脑血管疾病、骨关节疾病、神经疾病、糖尿病、肺部感染疾病,特别是高血压,宣教时应把这些老年人作为重点,这样社区宣教才能达到预期效果。宣教内容除跌倒高危因素外,还应有跌倒致创伤的常用救护措施,其中要包括骨折、颅脑伤、颈髓伤的救护。
Objectives To understand the proportion of elderly people who fall in the elderly in pre-hospital emergency areas in the region and their injuries after the fall, and explore the relationship between common diseases and falls in the elderly and the role of community education in reducing trauma caused by falls in the elderly. Methods A retrospective, controlled study was conducted on all the elderly people who called for “120” for fall-related problems in the Qingyun District of Nanchang City from January 2013 to December 2014. The patients were divided into 2 groups Group, control group: January 1, 2013-December 31, 2013; experimental group: January 1, 2014-December 31, 2014 In 2014, 50 communities under the jurisdiction of Qingyun District carried out the risk factors for falls of the elderly And fall after the mission-related knowledge of ambulance, the elderly were collected two sets of cases of falls in pre-hospital emergency, and its in-hospital examination, diagnosis, hospitalization, surgery continue to be tracked. Results Compared with 2013, the elderly in Qingyun area increased by 0.64% in 2014 and 8.45% in the elderly who called for “120”. However, after community education, the elderly with “120” asking for help due to fall-related problems People reduced by 14.75%; 2 groups of call for help “120 ” time comparison, the difference was statistically significant (χ ~ 2 = 10.444, P = 0.034), the elderly fell to call for help There was significant difference in the number of trauma between the two groups (χ ~ 2 = 6.162, P = 0.046). The number of traumatic brain injury and fractures decreased significantly after mission in community, but the sprain and muscle strain were increased. There was no significant difference between the two groups (χ ~ 2 = 11.15, P = 0.266). Community education can not change the types of underlying diseases that fall to the elderly. However, some diseases are closely related to falls. Conclusion Community education can reduce the rate of trauma caused by falls, as early as the professional rescue and treatment can reduce unnecessary secondary damage and complications. Mostly elderly people suffer from cardiovascular and cerebrovascular diseases, bone and joint diseases, neurological diseases, diabetes, lung infections, especially high blood pressure, mission should focus on these elderly people, so that community education can achieve the desired results. In addition to the content of the risk of falling elements of the mission, there should be traumatic fall injury common ambulance measures, including the fracture, head injury, cervical cord injury rescue.