膝关节骨性关节炎患者跌倒发生率及其危险因素的Meta分析

doi:10.3761/j.issn.0254-1769.2025.10.004

摘要/Abstract

摘要：

目的通过Meta分析明确膝关节骨性关节炎（knee osteoarthritis，KOA）患者跌倒的发生率和危险因素，旨在为实施针对性的干预提供借鉴。方法计算机检索中国知网、维普数据库、万方数据库、中国生物医学文献数据库、PubMed、Cochrane Library、Embase、Web of Science等数据库中关于KOA患者跌倒危险因素的文献，检索时限为建库至2024年8月。经文献筛选、资料提取、质量评价后，采用RevMan 5.4软件进行Meta分析。结果共纳入26篇文献。KOA患者的跌倒发生率为29.0%。差异有统计学意义的危险因素为女性（OR=1.35）、下肢肌力下降（OR=1.72）、膝关节屈肌肌力下降（OR=7.05）、静态姿势稳定性下降（OR=1.28）、使用阿片类药物（OR=1.79）、使用抗抑郁药（OR=1.69）、经常爬楼梯（OR=7.58）、合并神经系统疾病（OR=1.77）、有跌倒史（OR=3.29）、存在跌倒恐惧心理（OR=2.54）。结论 KOA患者的跌倒发生率较高，女性、下肢肌力越低、膝关节屈肌肌力越低、静态姿势稳定性越差、使用阿片类药物、使用抗抑郁药、经常爬楼梯、合并神经系统疾病、有跌倒史和存在跌倒恐惧的KOA患者发生跌倒的风险越高。医护人员应动态评估和监测KOA患者跌倒的危险因素，采取针对性、个体化干预措施预防跌倒的发生。

关键词: 骨关节炎, 膝, 跌倒, 危险因素, Meta分析, 循证护理学

Abstract:

Objective To clarify the evidence of the frequency and risk factors for falls in knee osteoarthritis（KOA） of adults by meta-analysis. Methods Computerized searches of the CNKI，VIP，Wanfang data，CBM，PubMed，Cochrane Library，Embase，Web of Science were conducted for literature on risk factors for falls in adults with KOA from the inception of the databases to August 2024. After literature screening，data extraction，and quality evaluation，RevMan 5.4 software was used for Meta-analysis. Results A total of 26 articles were involved.Meta-analysis result showed that the rate of falls was 29.0%.Factors associated with increased risk of falls included being female（OR=1.35），decreased lower limb muscle strength（OR=1.72），decreased knee flexion muscle strength（OR=7.05），decreased static posture stability（OR=1.28），opioid use（OR=1.79），antidepressant use（OR=1.69），frequent stair climbing（OR=7.58），combined neurological disease（OR=1.77），history of falls（OR=3.29）and fear of falling（OR=2.54）. Conclusion The rate of falls of patients with KOA is high. The adults with KOA who are women，have lower muscle strength of lower limbs and knee flexion muscle strength，poorer static posture stability，use opioids，antidepressant，frequent stair climbing，combined neurological disorders，previous falls in the past year and fear of falls are at higher risk of falls.Healthcare professionals should dynamically assess and detect the risk of falls in the patients with KOA and adopt targeted，individualized interventions to prevent falls.

Key words: Osteoarthritis, Knee, Falls, Risk Factors, Meta-Analysis, Evidence-Based Nursing

加悦悦, 杨支兰, 翟艳萍, 史宏睿, 赵慧敏, 晋源媛, 刘星宇, 延芝丽, 田紫薇. 膝关节骨性关节炎患者跌倒发生率及其危险因素的Meta分析[J]. 中华护理杂志, 2025, 60(10): 1177-1183.

JIA Yueyue, YANG Zhilan, ZHAI Yanping, SHI Hongrui, ZHAO Huimin, JIN Yuanyuan, LIU Xingyu, YAN Zhili, TIAN Ziwei. Prevalence and risk factors of falls in patients with knee osteoarthritis：a Meta-analysis[J]. Chinese Journal of Nursing, 2025, 60(10): 1177-1183.

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