军事训练中发生髌尖末端病的发病率调查(英文)

Investigation of the incidence of patellar tendinosis in military training

背景:在军事训练中如训练方法不当,容易导致各种训练伤的发生,髌尖末端病即是训练伤的一种。目的:探讨军事训练所致髌尖末端病的发病特点及其实施干预措施前后的发病率变化。设计:抽样调查。单位:广州军区广州总医院骨科,驻香港部队医院外科。对象:观察对象为2000-08(非干预组)和2001-08(干预组)某全训部队在同样训练大纲下进行训练的18～24岁男性陆军战士,非干预组共调查2783名战士,干预组共调查5824名战士。方法:由具有高、中级技术职称职的医务人员组成调查小组,调查前统一诊断标准,采用问卷调查和现场检查相结合的方式,对问卷中有训练后膝关节疼痛病史者均进行现场检查,对符合诊断者详细了解训练情况及导致该病的致病因素,并进行患膝X射线检查。非干预组为未进行预防干预的情况下于某全训部队部分连队调查髌尖末端病的发病率及病因。干预组为制定防治措施并进行预防和治疗干预,1年后再次于该部进行调查,了解干预后的结果。主要观察指标:两次调查的战士中患髌尖末端病的发病率。结果:第1次共调查2783名战士,第2次共调查5824名战士,均进入结果分析,无脱落者。①非干预组中有17名患髌尖末端病,发病率为0.61%;干预组有15名患髌尖末端病,发病率为0.26%(P<0.01)。②两次调查患病的32名患者中,均有髌尖疼痛症状及典型压痛体征,12个髌骨X射线检查有髌尖延长及“眼泡征”。③致病因素:主要与跑跳训练项目有关,23名为400m障碍训练所致,7名为5km越野训练所致。结论:军事训练所致髌尖末端病多由跑跳训练项目所致,通过预防干预可使发病率明显下降。

BACKGROUND： Improper practice during military training is likely to cause various training wounds, among which patellar tendinosis is the cornmon one.OBJECTIVE： To explore the onset characteristics of patellar tendinosis caused by military training and incidence changes after the implementation of interventions. DESIGN： Sampling investigation. SETTING： Department of Orthopedics, Guangzhou General Hospital of Guangzhou Military Area Command of Chinese PLA; Department of Surgery, Hospital of Chinese PLA Garrison in Hong Kong PARTICIPANTS： Male army soldiers aged 18-24 years were recruited from a full-time training array in August 2000 （non-intervention group） and August 2001 （intervention group）. The same training program was carried out among the 2,783 soldiers in non-intervention group and 5,824 soldiers in the intervention group. METHODS： The investigation group was composed of medical workers with senior and intermediate professional titles. Uniform diagnostic standard was made before the investigation, and questionnaire survey was combined with on-the-spot inspection on soldiers who complained about knee joint pain following training. Those who conformed to the diagnosis were inquired of their training state in detail and possible causes; meanwhile knee X-ray examination was also conducted. Soldiers in the non- intervention group were subjected to the investigation of the incidence and cause of patellar tendinosis due to fulltime training without given any preventive intervention. By contrast, soldiers in the intervention group were given preventive and therapeutic interventions and then subjected to the investigation into the interventional outcomes one year later. MAIN OUTCOME MEASURES： The incidence of patellar tendinosis in soldiers of the two groups. RESULTS： The first and second investigations were conducted on the 2 783 soldiers and 5 824 soldiers, respectively. All of them entered the resuh analysis with no loss. ①Patellar tendinosis was diagnosed in 17 soldiers of the non-intervention group （the incidence of 0.61%） as compared to 15 soldiers in the intervention group （the incidence of 0.26%） （P 〈 0.01）. ② These 32 patients displayed obvious patellar ending ache and typical tenderness. Patellar bone X-ray inspection on 12 of them displayed patellar tip extension and “optic vesicle signs”. ③Pathogenic factors： It was associated with run-jump training projects; 23 cases were caused by 400 mbarrier training and 7 cases by 5 km cross-country training. CONCLUSION： Patellar tendinosis during military training is mostly caused by run-jump training and can be remarkably prevented by preventive interventions.