军人与非军人腰椎间盘摘除术后的疗效对比分析  

Comparison of lumbar discectomy outcomes between military personnel and civilians

作　　者：邹重文[1] 陆焱[1] 罗伟国[1] 

机构地区：[1]解放军第187医院骨科,海南海口571159

出　　处：《临床军医杂志》2014年第5期472-474,共3页Clinical Journal of Medical Officers

摘　　要：目的比较军人与非军人腰椎间盘摘除术后的疗效。方法将我院收治并确诊为腰椎间盘突出症的87例军人(45例野战部队军人,42例机关军人)和87例非军人分成军人与非军人两组,均在持续硬膜外麻醉下行常规腰椎间盘摘除术。术后均随访6个月,记录所有患者个人信息、随访期末工作能力恢复情况、术后1、3、6个月疼痛VAS评分、Roland-Morris失能量表、对手术效果是否满意,并进行组间统计学分析。结果术后VAS评分显示所有患者术后疼痛显著缓解,但军人组疼痛缓解程度较差,与非军人组比较有统计学差异(P<0.05),Roland-Morris评分显示术后所有患者生活自理能力显著提高,但军人组术后恢复情况较非军人组差,两组比较,有统计学差异(P<0.05)。随访期末军人组恢复原有工作强度人数低于非军人组(P<0.05),而野战部队军人恢复原有工作强度人数又低于机关工作的军人(P<0.05);军人组术后残留腰痛症状比例较非军人高,两组比较有统计学差异(P<0.05);术后军人组对手术效果满意率为79.3%,显著低于非军人组的90.8%(P<0.05)。结论相对于非军人,军人椎间盘摘除术后整体效果较差,可能与军人职业的特殊性有关,因此,在军事训练中加强腰椎疾患的预防和健康教育尤为重要。Objective To compare the results of discectomy for lumbar disc herniation between milita^-/ personnel and civilians. Methods Subjects consisted of 87 military patients （45 from combat forces, 42 from administrative organ） and 87 civilian pa- tients, who were diagnosed as lumbar disc herniation and underwent diseeetomy. In duration of 6 months, the ability to return to full duty, the VAS value and the Roland-Morris disability questionnaire were assessed and the satisfaction was measured. Results The VAS and Roland-Morris value were significant decreased after operation, especially in the civilians which were lower than that in the military personnel. Inability to return to previous duty was significantly higher in the military personnel than in the civilians （P 〈 O. 05 ）, and so was in combat fighters than office personnel （ P 〈 0.05 ）. Military personnel had more complaints after surgery （ P 〈 0.05 ）. The mean satisfaction was 90.8% in the civilians and 79.3% in the military personnel, respectively （P 〈 0.05 ）. This difference was also seen in military subgroup forces. Conclusion Surgical intervention has relatively poor outcomes in military personnel, specifically in combat forces. Prevention of injury to back and waist region should be considered in military training.

关 键 词：腰椎间盘突出症 腰椎间盘摘除术 军人 非军人 

分 类 号：R681.53[医药卫生—骨科学]