装甲步兵骨关节源性下腰痛调查与分析

The epidemiological investigation and analysis of bone-derived low back pain in armored infantry

目的抽样调查某部装甲步兵职业性骨关节源性下腰痛的发生原因及分布情况，探讨其流行特征及预防措施。方法以问卷结合体格检查的方式，依照《军事训练伤诊断标准及防治原则》（WSB38—2001）中所规定军事训练所致下腰痛的诊断标准，对某部参训装甲步兵进行骨关节源性下腰痛流行病学调查，采集数据资料，并进行相关分析。结果被筛选调查的402名参训装甲步兵罹患下腰痛113例，发生率28．11％。其中骨关节源性下腰痛24例．发生率为5．97％，占下腰痛人员比例21．24％。≥2年军龄骨关节源型下腰痛发病率为10．93％，明显高于≤1年军龄组的5．19％和1—2年军龄组的4．76％（P〈0．05）。在骨关节源性下腰痛24名战士中，乘员17名，所占比例高达70．83％，载员7名，占29．17％。装甲乘员比例明显高于装甲载员（P〈0．05）。24例装甲步兵组骨关节源性下腰痛伤员中，I度疼痛患者发生率较高（3．98％），明显高于Ⅱ度疼痛伤员（1．49％）（P0O．05），Ⅲ度以上的患者发生率极低，仅为0．50％，三组发病率比较有统计学意义（P〈0．05）。此外，腰背肌相对肌力素质锻炼的方法进行干预治疗，结果没有新增骨关节源性下腰痛伤员，且有7名骨关节源性下腰痛伤员症状减轻。结论通过调查发现，装甲步兵下腰痛发病率较高，骨关节源性下腰痛所占比例不可忽视，主要集中在I〉2年军龄，其中装甲乘员明显高于装甲载员，腰背肌相对肌力素质锻炼对于骨关节源性下腰痛的预防和治疗均具有明显的效果。因此，在平常的军事训练及作业中，应该加强腰背肌锻炼及健康宣教工作，减少骨关节源性下腰痛的发生。

Objective To investigate the cause and the distribution of bone-derived low back pain of armored infantry and to discuss the epidemiological features and preventions. Methods Combined with the questionnaire and physical examination,authors conducted the epidemiological investigation and the analysis on bone-derived low back pain of armored infantry based on the diagnostic criteria provided by the military servicemen diagnostic criteria and principles of prevention and control （WSB38-2001）. Results Of all 402 armored infantry,ll3 participants had low back pain,accounted for 28.11%. Among the armored infantry bothered by low back pain,24 were bothered by bone-derived low back pain,accounted for 5.97% of all participants and 21.24% of all participants with low back pain. The bone-derived low back pain incidence in 2-years-after- enrolled-into-army group was 10.93%,which was much higher than 1-year with 5.19% and 1-2-years group with 4.76%（P〈0.05）. of 24 soldiers with bone-derived low back pain,17 were staff working on vehicles accounted for 70.83% while 7 were the carried soldiers accounted for 29.17%. Obviously,the staff working on vehicles had higher incidence than the carried soldiers （P〈0.05）. Of 24 cases with bone-derived low back pain,who with [ degree of pain were higher patient（3.98%）,significantly higher than II degree（1.49%）（P〈0.05）. The incidence of III degree pain was extremely low,only accounted for 0.50%. There was significant difference among three groups （P〈0.05）. In addition,Authors taught the soldiers relative strength exercise of low back muscle and not only there was no new soldiers with low back pain emerging,but also 7 soldiers with low back pain was in relief. Conclusions Low back pain has a high incidence in armored infantry. Bone-derived back pain could not be ignored. The years enrolled into army mainly focused on 2 or more years. And the incidence of staff working on vehicles is significantly higher than that of carried soldiers. The relative muscle strength exercise is very effective for prevention and treatment of bone-derived low back pain. So it should be better to enhance the relative strength exercise of low back muscle for reducing bone-derived low back pain.