2003-2008年住院精神障碍患者跌倒损伤原因分析

目的:探讨住院精神障碍患者跌倒损伤的原因.方法:回顾分析2003-2008年上海市精神卫生中心住院患者发生跌倒损伤的可能因素,分老年组与非老年组进行比较.结果:6年跌倒损伤患者55例,跌倒损伤率3.6‰,其中女性40例,平均年龄(66.33±13.85)岁,60岁以上患者34例.46例(83.6%)服用抗精神病药物,其中19例(34.5%)合并服用2种以上抗精神病药、32例(58.2%)合并服用苯二氮(艹卓)类药物.跌倒发生的场所以厕所旁比例最高(50.9%).与非老年组相比,跌伤老人存在视听功能障碍者多(35.5% vs 0)、服药种类多(6.12±1.87)vs(3.81±1.94)种]、抗精神病药服用剂量较低(194.88±211.56) vs(389.10±284.01)mg ]、骨折发生率较高(94.1% vs 61.9%),两组相比均存在显著差异(P＜0.01).结论:年龄大、女性、服用抗精神病药物与苯二氮(艹卓)类药、上厕所可能是精神障碍患者跌倒损伤者的危险因素.老年患者跌倒后损伤更重.

Analysis of the causes of injured fall for inpatients with mental disorder from 2003 to 2008

Objective： To investigate the causes of injured fall among the in-patients with mental disorders. Methods： The factors related to the injured fall among the inpatients in Shanghai Mental Health Center during 6 years from 2003 to 2008 were retrospectively analyzed. Inpatients were divided into elderly group and adult group, which were compared. Results： There were 55 inpatients with injured fall in 6 years （rate was 3.6‰ ）, of which 40 were women with average age 66.33± 13.85 and 34 patients were over 60 years old. Among forty six cases taking antipsychotic drugs, nineteen patients （34.5%） had been taking more than two antipsychotic drugs and thirty two （58.2%） taking benzodiazepines. Most fall happened by the toilet （50.9%）. Compared with adult group, the elderly had higher audio-visual dysfunction （35.5% vs 0） and higher incidence of fractures （94.1% vs 61.9%） took no less than two kinds of drugs （6.12 ± 1.87 vs 3.81 ± 1.94） and lower dose of antipsychotic drugs （194.88 ＋± 211.56 mg vs 389.10± 284.01 mg）. Conclusions： The aged women with mental disorders and taking antipsychotics and benzodiazepines are the main risk factors of injured fall when going to toilet. Elderly patients might be more serious injuries from fall because of multiple factors.