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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: In military training, improper training methods can easily lead to various training injuries. Patellar tip disease is a kind of training injury. Objective: To investigate the incidence of patellofemoral tip disease caused by military training and the changes of morbidity before and after the implementation of interventional measures. Design: sample survey. Unit: Guangzhou General Hospital of Guangzhou Military Region Orthopedics, Surgery, Hong Kong Force Hospital. PARTICIPANTS: Subjects were male warriors aged 18-24 who underwent training in the same training program in 2000-08 (non-intervention group) and 2001-08 (intervention group). The non-intervention group investigated 2,783 soldiers, Intervention group surveyed a total of 5,824 soldiers. Methods: A medical team with high and mid-level professional titles formed a team of investigators. Uniform diagnostic criteria were collected before the survey. A questionnaire survey and on-site examination were used to conduct on-site examination of those with a history of knee pain after training in the questionnaire. For those who meet the diagnosis of a detailed understanding of the training and the pathogenic factors leading to the disease, and knee X-ray examination. In the non-intervention group, the incidence and etiology of patellar tip-end disease were investigated in some of the whole training units without preventive intervention. Intervention group to develop prevention measures and prevention and treatment interventions, again after 1 year to investigate the Department to understand the results after the intervention. MAIN OUTCOME MEASURES: The incidence of patellar tip disease in two surveys of soldiers. Results: The first survey of 2783 soldiers, the second survey of 5,824 soldiers, all into the analysis of the results, no shedding. ① In the non-intervention group, 17 patients had patellofemoral terminal disease, the incidence rate was 0.61%. In the intervention group, 15 patients had patellofemoral terminal disease with the incidence of 0.26% (P <0.01). ② In the two surveys, 32 patients with patellar pain and typical symptoms of tenderness had patellar tip prolongation and “ophthalmoplegia” in 12 patella X-ray examinations. ③ risk factors: Mainly related to running training and jumping, 23 were due to 400m obstacle training, 7 were due to 5km off-road training. Conclusions: Most of the patellofemoral terminal diseases caused by military training are caused by running training programs. The incidence of patellar tip disease can be significantly reduced by preventive intervention.