军事飞行员颈部积累伤的研究

Cumulative neck injuries in military pilots

目的调查军事飞行员的颈部积累伤现状,了解患病情况、常规治疗措施及康复疗效,为开展相应的颈部积累伤的防控康复体系提供依据。方法对816例军事飞行员进行问卷调查同时采集颈部MRI等检查资料,包括歼击机(普通歼击机、高性能战斗机)、运输机、轰炸机、直升机飞行员。飞行员信息分为四部分:(1)一般情况:年龄、身高、体质量、BMI、颈围、颈厚等;(2)职业相关情况:包含机种、机型、飞行时间等;(3)情绪状态和睡眠状况;(4)颈部损伤情况(颈部症状及发生时间、康复措施等),颈部的功能评定以及颈部MRI检查结果,对上述情况进行统计分析。结果本研究调查的816例飞行员诊断为颈部积累伤的为243例,患病率为29.8%;高性能战斗机飞行员患病率最高,为47.4%,普通歼击机飞行员、轰炸机、运输机、直升机飞行员患病率分别为29.9%、26.8%、24.5%和27.8%,差异有统计学意义(χ^(2)=21.279,P=0.0003);反复发生颈部不适和疼痛的比例为59.4%和41.9%;颈部MRI结果显示,颈部退行性变、椎间盘突出、椎间盘膨出的比例为54.0%、32.6%和30.6%;年龄、BMI值、飞行因素、睡眠问题、焦虑因素等是颈部积累伤的危险因素;颈部锻炼为患颈部积累伤的保护因素。有16.5%颈部积累伤的飞行员未予任何治疗,康复措施以手法、电疗最为常见。结论颈部积累伤在军事飞行员中发病率高,随着我军主战机型更新换代和高强度训练的常态化,颈部积累伤增加趋势日益显著,对日常生活、训练有严重影响,危及飞行安全。颈部积累伤问题应引起各方高度关注,尤其是航卫保障工作者应深入研究此类问题的应对方案。

Objective To investigate the prevalence of cumulative neck injuries in military pilots via analysis of risk factors,impacts,conventional treatments and therapeutic effect so as to provide data for related prevention and treatment.Methods A total of 816 military pilots,including pilots for fighters,bombers,transport aircraft and helicopters,were investigated via questionnaires,and data from neck MRI and other examinations was collected.The questionnaire consisted of four parts:①pilots'basic information,such as age,height,weight,neck circumference and neck depth,©factors related to their occupations,such as types of aircraft,models of aircraft,and flying hours,©scores of the pilots'self-rating emotional scale(including SDS and SAS)and the Pittsburgh Sleep Quality Index(PSQI).④neck injuries and results of neck function evaluation and neck MRI.The data was analyzed statistically.Results Two hundred and forty-three of the 816 pilots were diagnosed with cumulative neck injuries,and the incidence was 29.8%.These injuries were the most prevalent among aircraft pilots of the third generation and above(47.4%),compared with 29.9%,26.8%,24.5%and 27.8%among pilots of aircraft of the second generation,bombers,transport aircraft and helicopters respectively.There was significant difference between pilots of different aircraft(x^(2)=21.279,P=0.0003).The proportion of recurrent neck discomfort and pain was 59.4%and 41.9%respectively.The results of cervical MRI showed that the proportions of cervical degeneration,intervertebral disc protrusion and intervertebral disc protrusion were 54.0%,32.6%and 30.6%respectively.Age,BMI,flight-related factors,sleep disorders and anxiety were risk factors for neck cumulative injuries while neck exercise was a protective factor.Massage and electrotherapy were most common treatments of cumulative neck injuries.Conclusion Cumulative neck injuries have become common among Chinese military pilots and are trending up,which has adverse effect on daily flight training and safety.More efforts should be devoted to the prevention of these injuries.