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问题库/老人与照护

老人眼睛看不清、走路老摔,白内障要不要做

2 条依据 · 约 550 字 · 出处逐条列出

影响看路就去做。70 岁以上女性尽快做第一只眼,一年里跌倒次数少约三成四,髋部骨折低约一成六。两只眼都有白内障的,第二只别拖太久。

这里不保证什么

能不能做要眼科评估,血压血糖没控制好的先处理;摔跤也可能是腿脚、吃药、地滑,别只盯着眼睛。

展开看依据2 条 · 点标题进原条目

老人的白内障已经影响看路,就去眼科评估做手术;两只眼都有的,第二只别拖太久

70 岁以上的女性尽快做第一只眼的白内障手术,一年里跌倒的次数少约三成四,骨折的人也少了。但摔过跤的人数没有少。第二只眼做不做,跌倒上没看出明显差别。做了手术的老人,一年内髋部骨折低约一成六。

  • 陪老人去眼科查一次,由医生判断该不该做、哪只眼先做
  • 术前问清人工晶体选哪种、自己掏多少钱,很多医院当天回家
  • 做完第一只眼那段,走路和上下楼格外小心,别自己骑车

坑手术减少的是跌倒次数,摔过跤的人数没有明显减少;帮老人处理视力问题的干预试验里,跌倒次数反而多了约五成七。

成本:先陪老人去眼科查一次,由医生判断该不该做。一只眼做一次手术,很多医院按日间手术做,当天就能回家。两只眼都有白内障的,要分两次做。自己掏多少钱,看换进眼里的人工晶体(人造镜片)选哪种、当地医保怎么报,术前问清楚。第 17 节 · 家里有老人

出处

Harwood RH, Foss AJ, Osborn F, Gregson RM, Zaman A, Masud T (2005). Falls and health status in elderly women following first eye cataract surgery: a randomised controlled trial. British Journal of Ophthalmology, 89(1), 53-59. <https://doi.org/10.1136/bjo.2004.049478> ; Foss AJ, Harwood RH, Osborn F, Gregson RM, Zaman A, Masud T (2006). Falls and health status in elderly women following second eye cataract surgery: a randomised controlled trial. Age and Ageing, 35(1), 66-71. <https://doi.org/10.1093/ageing/afj005> ; Gillespie LD, Robertson MC, Gillespie WJ, et al. (2012). Interventions for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews, 9, CD007146. <https://doi.org/10.1002/14651858.CD007146.pub3> ; Tseng VL, Yu F, Lum F, Coleman AL (2012). Risk of fractures following cataract surgery in Medicare beneficiaries. JAMA, 308(5), 493-501. <https://doi.org/10.1001/jama.2012.9014> ; Desapriya E, Subzwari S, Scime-Beltrano G, et al. (2010). Vision improvement and reduction in falls after expedited cataract surgery: systematic review and metaanalysis. Journal of Cataract and Refractive Surgery, 36(1), 13-19. <https://doi.org/10.1016/j.jcrs.2009.07.032> ; Meuleners LB, Lee AH, Ng JQ, Morlet N, Fraser ML (2012). First eye cataract surgery and hospitalization from injuries due to a fall: a population-based study. Journal of the American Geriatrics Society, 60(9), 1730-1733. <https://doi.org/10.1111/j.1532-5415.2012.04098.x> ; Meuleners LB, Fraser ML, Ng J, Morlet N (2014). The impact of first- and second-eye cataract surgery on injurious falls that require hospitalisation: a whole-population study. Age and Ageing, 43(3), 341-346. <https://doi.org/10.1093/ageing/aft177> ; Keay L, Ho KC, Rogers K, et al. (2022). The incidence of falls after first and second eye cataract surgery: a longitudinal cohort study. Medical Journal of Australia, 217(2), 94-99. <https://doi.org/10.5694/mja2.51611> ; 国家卫生健康委 (2022). 「十四五」全国眼健康规划(2021-2025年). <https://www.gov.cn/zhengce/zhengceku/2022-01/17/content_5668951.htm>

家里老人遛狗,把牵绳握在手心、别缠在手上,绳子收短,狗先训练到牵着不往前猛冲

美国 65 岁以上的人遛狗摔骨折,2004 年约 1700 人,2017 年约 4400 人。八成是女性,近三成要住院,按单个部位算髋部骨折最多。一家手外科门诊的狗绳伤手病人,约四分之三是绳子缠手、狗一拽造成的。所以绳子握在手心、收短,狗训练到不往前冲。

  • 把牵绳握在手心,别绕在手腕和手指上,绳子收短
  • 把狗训练到牵着不往前猛冲,自己教或请训犬师
  • 把伸缩绳放长用改成收短,走路时不看手机、不走车道边

坑握在手心护的是手指和手腕,防不住狗猛冲时把人拽倒;伸缩绳放长了就是长绳,但没有研究专门比过哪种绳更容易摔。

成本:握绳和收短绳子不花钱,陪老人走一趟、教一遍就行。训练狗不往前冲要花时间,自己教或者请训犬师都行,请人要花钱,各地价格差很多。难在老人用惯了伸缩绳、习惯把绳子绕在手腕上,要让他改。第 17 节 · 家里有老人

出处

Pirruccio K, Yoon YM, Ahn J (2019). Fractures in Elderly Americans Associated With Walking Leashed Dogs. JAMA Surgery, 154(5), 458-459. <https://doi.org/10.1001/jamasurg.2019.0061>;Forrester MB (2020). Dog leash-related injuries treated at emergency departments. American Journal of Emergency Medicine, 38(9), 1782-1786. <https://doi.org/10.1016/j.ajem.2020.05.082>;Plusch K, Givner D, Wiafe B, Lutsky K, Beredjiklian P (2026). Hand and Wrist Dog-Leash Injuries in the Outpatient Setting: A Review of 443 Cases. Hand, 21(4), 582-586. <https://doi.org/10.1177/15589447241299128>;CDC (2009). Nonfatal fall-related injuries associated with dogs and cats — United States, 2001-2006. MMWR, 58(11), 277-281. <https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5811a1.htm>;Rosa R, Buckley RE (2024). Leash-related injuries associated with dog walking: an understudied risk for dog owners? Journal of the American Veterinary Medical Association, 262(7), 973-978. <https://doi.org/10.2460/javma.23.11.0608>

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这条回答是给一个正在着急的人写的,不是法律意见或医嘱。 金额大、动到人身、或者已经进到程序里,去找律师、医生和办事窗口。