1954-2022年陕西省富县大骨节病防治情况流行病学调查  

Epidemiological investigation of Kaschin-Beck disease prevention and control in Fu County,Shaanxi Province from 1954 to 2022

作　　者：陈翔宇 刘海滨 温萌 鲁洋 孙晨皓 尹军相 颜连启[1] Chen Xiangyu;Liu Haibin;Wen Meng;Lu Yang;Sun Chenhao;Yin Junxiang;Yan Lianqi(Department of Joint Surgery,Northern Jiangsu People'Hospital Affiliated to Medical College of Yangzhou University,Yangzhou 225001,China;Orthopedics Department,People's Hospital of Fu County,Yan'an City,Shaanxi Province,Yan'an 727500,China;Acute Infectious Disease Prevention and Control Department,Center for Disease Prevention and Control of Baoying County,Yangzhou City,Jiangsu Province,Yangzhou 225800,China;Department for Endemic and Chronic Diseases Prevention and Treatment,Health Bureau of Fu County,Yan'an City,Shaanxi Province,Yan'an 727500,China)

机构地区：[1]扬州大学医学院附属苏北人民医院关节外科,扬州225001 [2]陕西省延安市富县人民医院骨科,延安727500 [3]江苏省扬州市宝应县疾病与预防控制中心急性传染病防制科,扬州225800 [4]陕西省延安市富县卫生健康局地方病与慢性病防治办公室,延安727500

出　　处：《中华地方病学杂志》2023年第3期216-221,共6页Chinese Journal of Endemiology

摘　　要：目的:分析陕西省富县大骨节病的防治情况,为巩固大骨节病防控成果及治疗现症患者提供依据。方法:1954-2022年大骨节病流行病学调查资料和临床资料分别来自陕西省富县地方病防治所和富县人民医院。采用回顾性研究方法,了解通过易地搬迁、换粮、改水、退耕还林等综合措施,富县大骨节病的防治情况。结果:1954年,富县共有6个大骨节病病区乡、127个病区村,总人口数为78 781人,X线检查共检出大骨节病患者16 327例,检出率为20.72%。其中有X线改变的无临床症状者5 434例,现症患者中临床Ⅰ度5 850例、Ⅱ度3 725例、Ⅲ度1 318例。1975年,对全县进行第一次大骨节病普查,普查人数为101 341人,X线检查共检出大骨节病患者9 575例,检出率为9.45%,其中无临床症状者3 247例,现症患者中临床Ⅰ度3 704例、Ⅱ度2 006例、Ⅲ度618例。大骨节病患者以本地居民为主,占93.92%(8 993/9 575)。1997年,对15个乡镇的342所学校的27 320名7~16岁未成年人进行X线检查,发现有X线改变的无临床症状者169例,临床Ⅰ度患者仅2例,检出率降为0.63%。1997年,富县开始鼓励易地搬迁与换粮预防大骨节病,搬迁对象主要是儿童中有新发病例且生活条件差的重病村,至1999年共搬迁100户、469人;至2020年,共搬迁1 569户、5 334人。1997和1998年,对6个乡镇的43个自然村采取改善水质措施,有1 591户、7 375人获益。2010年,对富县15个乡镇进行大骨节病普查,普查人数为135 858人,X线检查检出大骨节病患者3 424例,检出率为2.52%。现症患者2 885例,其中临床Ⅰ度1 584例、Ⅱ度1 024例、Ⅲ度277例。16岁以下未成年人检查32 561人,X线检出大骨节病患者49例,检出率为0.15%,均为Ⅰ度患者。2014年,在富县170个病区村共计普查73 600人,X线检查检出大骨节病患者2 885例,检出率为3.92%。与2010年比较实现了大骨节病患者零增长,且连续4年无16岁以下患者。至2016年Objective To analyze the prevention and treatment of Kaschin-Beck disease in Fu County,Shaanxi Province,so as to provide basis for consolidating the results of Kaschin-Beck disease prevention and control and the treatment of patients with Kaschin-Beck disease.Methods The epidemiological investigation of data and clinical data Kaschin-Beck disease from 1954 to 2022 were collected from the Fu County Institute for Endemic Disease Prevention and Control and People's Hospital of Fu County in Shaanxi Province,respectively.The retrospective study was used to investigate the prevention and control of Kaschin-Beck disease in Fu County through the adoption of comprehensive measures such as relocation,grain exchange,water improvement,conversion of farmland to forest and so on.Results In 1954,there were 6 endemic townships and 127 endemic villages of Kaschin-Beck disease in Fu County,with a total population of 78781.A total of 16327 patients with Kaschin-Beck disease were detected by X-ray examination,with a detection rate of 20.72%,including 5434 patients without clinical symptoms.There were 5850 patients with clinical grade I,3725 patients with clinical grade I and 1318 patients with clinical grade II.In 1975,the first general survey of Kaschin-Beck disease was conducted in the whole county,with a total population of 101341.A total of 9575 patients with Kaschin-Beck disease were detected by X-ray examination,with a detection rate of 9.45%,including 3247 cases without clinical symptoms.Among the patients with symptoms,there were 3704 cases of clinical grade I,2006 cases of clinical grade I and 618 cases of clinical grade II.The patients with Kaschin-Beck disease were mainly local residents,accounting for 93.92%(8993/9575).In 1997,27320 students aged 7 to 16 years in 342 schools of 15 townships were examined and found that there were 169 cases without clinical symptoms with X-ray changes,only 2 cases with clinical grade I,and the detection rate decreased to 0.63%.In 1997,Fu County began to encourage relocation and grain exch

关 键 词：大骨节病 防治效果 流行病学调查 

分 类 号：R684.1[医药卫生—骨科学] R181.3[医药卫生—外科学]