肿瘤患者跌倒的原因分析及预防措施

目的分析肿瘤住院患者发生跌倒的原因，探讨有效的预防措施。方法回顾性分析我院4个放疗病区在2007年1月至2011年12月中19例发生跌倒意外的肿瘤住院患者的资料。结果跌倒病人中以41～50岁年龄段最多．有7例，占36．84％。所患疾病鼻咽癌最多，有13例，占68．42％；按照住院人数进行校正后，各病种发生率无明显差异；跌倒时间6：01—12：00最多，有11例，占57．90％；跌倒地点病房厕所最多，有8例，占42．11％。影响患者跌倒的因素包括体位性低血压，有8例，占42．11％；低血糖反应，有6例，占31．58％；脑部病变，有2例，占10．53％；药物反应，有1例，占5．26％；重视不足，有2例，占10．53％。结论针对患者的疾病、治疗后的反应等高危因素，采用以人为本、全程、有效的预防方法，加强沟通，强化医护人员及患者和其家属的安全意识，制定因人施教的防范措施，加强监督，落实到位，从而避免肿瘤住院患者发生跌倒的危险。

The causes and prevention measures of tumble in patients with cancer

Objective To analyze the causes of tumble in patients with cancer, and to explore effective prevention measures. Methods The data on 19 patients with cancer who occurred accidental tumble in theradiotherapy wards during the period of January 2007 to December 2011 were retrospectively analyzed. Results 7 （36.84%） patients were 41-50 years old. The patients were at the greatest risk of accidental tumble between this age range. 13 （68.42%） patients had nasopharyngeal carcinoma （NPC）. However, there was no difference among the cancer types corrected with the number of hospitalized patients. 11 （57.90%） patients tumbled between 6：01 am to 12：00 am. 8 （42.11%） patients developed tumble in bathrooms. The factors affecting tumble in patients included orthostatic hypotension in 8 patients, hypoglycemia reactions in 6, brain lesions in 2, adverse reaction in 1, and negligence in 2, which accounted for 42.11%, 31.58%, 10.53%, 5.26%, and 10.53%, respectively. Conclusions For the high-risk factors including patient conditions and treatment response, we need to provide patient-oriented, effective methods for tumble prevention such as enhancing communication with patients and their families, strengthening safety awareness in healthcare workers and patients, and developing individualized education precautious to intensify supervision in order to avoid the risks of tumble in hospitalized patients with cancer.