飞行人员腰痛保守治疗后飞行合格影响因素分析

Determinants of qualification after non-operative treatment of low back pain in aircrews

目的 探讨军事飞行人员腰痛保守治疗后影响飞行合格的因素,为提高复飞率,降低停飞率和地面观察率提供参考。方法 回顾性分析2016年1月—2018年12月在空军特色医学中心因腰痛采取保守治疗的90例飞行人员病历资料,按照2022年4月前在空军特色医学中心做的末次飞行结论分组,分为飞行合格组和飞行不合格组(含暂时飞行不合格),比较2组在年龄、性别、飞行时间、体质量指数(BMI)、腰痛、腰痛持续时间、下肢痛、下肢痛持续时间、腰椎MRI椎间盘退变节段数量、椎间盘突出部位、椎间盘突出程度等因素的差异及其与鉴定结论的影响关系。结果 仅年龄(χ^(2)=11.75,P=0.003)、飞行时间(χ^(2)=7.20,P=0.007)和BMI(χ^(2)=5.38,P=0.020)在2组间的差异具有统计学意义。Logistic回归分析显示飞行时间和BMI与飞行结论相关:飞行时间≥2 000 h是影响飞行结论的危险因素(OR=3.323,95%CI:1.273~8.676,P=0.014),BMI≥24 kg/m~2是影响飞行结论的危险因素(OR=3.073,95%CI:1.063~8.879,P=0.038)。结论 飞行时间≥2 000 h,BMI≥24 kg/m~2是飞行人员腰痛保守治疗后影响飞行合格的危险因素。

Objective To explore the factors affecting qualification after non-operative treatment of low back pain in aircrews,and to provide reference for improving the rate of resumption of flight and reducing the rate of grounding.Methods The medical records of 90 aircrews who received treatment of low back pain in Air Force Medical Center of PLA between January 2016 and December 2018 were retrospectively analyzed.These pilots were divided into the qualified group and the unqualified group(including temporarily unqualified)according to the conclusions from the last aviation medical identification conducted in Air Force Medical Center of PLA before April 2022.The two groups were compared in terms of age,gender,years of flight,BMI,low back pain,duration of low back pain,lower limb pain,duration of lower extremity pain,numbers of lumbar MRI disc degenerative segments,sites of disc herniation,and degree of disc herniation in order to analyze the correlations with outcomes.Results Only age(χ^(2)=11.75,P=0.003),years of flight(χ^(2)=7.20,P=0.007)and BMI(χ^(2)=5.383,P=0.020)were significantly different between the two groups.Logistic regression analysis showed that only durations of flight and BMI were associated with conclusions from medical identification.Conclusion Durations of flight of over 2000 h and BMI of over 24 kg/m2 are risk factors for qualification after non-operative treatment of low back pain in aircrews.