中国陆军热射病发病率和风险因素调查

Incidence of heatstroke and the related risk factors in army

目的调查处于中国北方沿海地区的陆军部队热射病发病率及影响因素，探讨有效预防措施。方法以问卷方式对陆驻扎在北方沿海地区的陆军某旅3000名士兵进行随机抽样调查，内容包括入伍前居住地、是否接受过热射病防治培训及训练前热习服、发病时环境因素及个人因素等。结果热射病总发病65例，总发病率2．19％；气温〉32℃、湿度〉60％环境下发病率86．15％，显著高于气温〈32℃、湿度〈60％下的发病率13．85％（P〈0．01）；训练前身体有不适感（疲劳感、头晕、恶心、腹泻等）发病率12．27％，显著高于训练前无身体不适1．15％（P〈0．01）；训练前24h睡眠不足4h发病率5．92％，显著高于睡眠多于4h以上0．91％（P〈0．05）；未接受热射病知识培训无热习服训练者发病率4．76％，显著高于接受过热射病知识培训并进行规范热习服者1．34％（P〈0．05）；入伍前不同居住地与发病率无明显相关性（P〉0．05）。结论士兵训练时环境温度和湿度及参训人员的身心状态是影响热射病发病的重要因素，规范化的热习服及热射病相关防治知识的培训是降低热射病发病率的重要措施。

Objective To investigate incidence of heatstroke （HS） in the army and the related risk factors associated with the military drills, and develop effective methods against HS. Methods A questionnair survey on incidence of HS was conducted among 3,000 soldiers who were randomly selected from the corps stationed in the northern coastal regions with all males aged in 18.32±1.13 years old. Among them 2,535 were natives of the northern part of China, and 435 of the southern part. Results It demonstrated a total of 65 soldiers who suffered from HS with an incidence rate of 2.19%. The incidence rate climbed up to 86.15% when the air temperature 〉 32℃ and humidity 〉 60%. It was significantly higher than that when the air temperature 〈 32℃ and humidity 〈 60% （13.85%, P 〈0.01）. It reflected an incidence rate of 12.27% when the soldiers felt under the weather which was significantly higher than that when healthy （1.15%, P 〈0.01）. The incidence rate of 5.92% was found when the their sleep time was less than 4 hours before training which was significantly higher than that when those sleep time was more than 4 hours （0.91%, P 〈0.01）. The incidence rate of those who had been trained on knowledge of HS and heat acclimatization was 1.34%, significantly lower than that of those who had never been trained （4.76%, P 〈0.01）. There was not significant correlatioin in the incidence of HS between the soldiers who lived in southern part and those who lived in the northern part before joinimg the army （P 〉0.05）. Conclusion The factors, such as air temperature, humidity, the health condition of a soldier, as well as his training background, are the risk factors to the HS incidence. Standardization of heat acclimatization and training on prevention and trerastment of HS are considered being imperative in reducing the morbidity of HS.