广东省超声医师工作相关肌肉骨骼疾患多部位发生模式分析  

Analysis on the characteristics and patterns of work-related musculoskeletal disorders among sonographers in Guangdong Province

作　　者：张丹英[1] 王丽敏[2] 伍颖恒 梁耀佳[2] 王会敏[2] 黄汉林[2] 张海春[4] 陈钟萍[5] 刘金蓉 马小燕[2] ZHANG Danying;WANG Limin;WU Yingheng;LIANG Yaojia;WANG Huimin;HUANG Hanlin;ZHANG Haichun;CHEN Zhongping;LIU Jinrong;MA Xiaoyan(Guangdong Province Hospital for Occupational Disease Prevention and Treatment,Guangzhou,Guangdong 510300,China;不详)

机构地区：[1]广东省职业病防治院,广东广州510300 [2]广东省妇幼保健院,广东广州511400 [3]广州市妇女儿童医疗中心,广东广州510623 [4]广东省第二人民医院,广东广州510310 [5]广东省人民医院,广东广州510080

出　　处：《中国职业医学》2023年第3期255-261,共7页China Occupational Medicine

基　　金：广东省医学科学技术研究基金(A20220097)。

摘　　要：目的分析广东省超声医师工作相关肌肉骨骼疾患(WMSDs)的患病特征,探讨其发生模式类别。方法采用分层整群抽样法,选择广东省31家医院512名超声医师为研究对象。采用《肌肉骨骼疾患调查问卷》调查其过去1年内WMSDs患病情况,分析WMSDs患病特征;采用潜在类别分析方法识别WMSDs发生模式。结果研究对象WMSDs患病率为94.3%;主要受累的前5个身体部位依次为右肩部、颈部、右手/腕部、下背部和右前臂/肘部,患病率分别为80.3%、75.4%、61.1%、55.5%和45.3%。右侧的肩部、手/腕部、前臂/肘部、臀/大腿部和膝部WMSDs患病率均高于左侧相同部位(80.3%vs 31.3%,61.1%vs 13.9%,45.3%vs 10.0%,17.4%vs 8.6%,13.1%vs 8.4%,P值均<0.05)。超声医师WMSDs患病率和5个主要受累身体部位的WMSDs患病率均随着其工龄的增加而升高(P值均<0.05)。但综合医院与妇幼保健医院、三级医院与非三级医院、珠江三角洲地区医院与非珠江三角洲地区医院、不同性别和不同年龄组超声医师WMSDs患病率分别比较,差异均无统计学意义(P值均>0.05)。超声医师WMSDs潜在类别模式以3个类别模型拟合程度最好,分别为颈右肩症状型、颈下背右肩右肘右手/腕症状型和膝以上多部位症状型,潜在分类概率依次为0.438、0.427和0.135。结论超声医师WMSDs患病率极高,且与工龄存在剂量-效应关系;常见患病部位为颈部、下背部和右侧的肩部、手/腕、前臂/肘;右侧肢体WMSDs患病率高于左侧。WMSDs以多部位症状共同发生为主,以颈右肩症状型和颈下背右肩右肘右手/腕症状型2种模式较为常见。Objective To analyze the characteristics of work-related musculoskeletal disorders(WMSDs)among sonographers in Guangdong Province,and to explore the disease pattern of the cases.Methods A total of 512 sonographers from 31 hospitals in Guangdong Province were selected as the research subjects using stratified cluster sampling method.The prevalence of WMSDs in the past year was investigated using the Musculoskeletal Disorders Questionnaire,and the characteristics of WMSDs were analyzed.Latent class analysis was used to identify the disease pattern of WMSDs.Results The overall prevalence of WMSDs was 94.3%.The top five affected body parts were right shoulder,neck,right hand/wrist,lower back and right forearm/elbow,with the prevalence of 80.3%,75.4%,61.1%,55.5%and 45.3%,respectively.The prevalence of WMSDs was higher on the right side for the shoulder,hand/wrist,forearm/elbow,hip/leg and knee compared with the left side(80.3%us 31.3%,61.1%vs 13.9%,45.3%vs 10.0%,17.4%us 8.6%,13.1%vs 8.4%,all P<0.05).The prevalence of WMSDs increased with work years,as well the prevalence of WMSDs in the top five affected body parts among the sonographers(all P<0.05).However,there were no statistical differences in prevalence of WMSDs between general hospitals and maternal and child health hospitals,tertiary hospitals and non-tertiary hospitals,Pearl River Delta hospitals and non-Pearl River Delta hospitals;there was also no statistical difference between different genders and age groups of the sonographers(all P>0.05).The best-fit latent disease pattern for sonographers WMSDs comprised three categories:symptom of neck-right shoulder,symptom of neck-lower back-right shoulder-right elbow-right hand/wrist,and symptom of multi-parts above the knees,with the latent probabilities of 0.438,0.427 and 0.135,respectively.Conclusion The prevalence of WMSDs in sonographers is extremely high,with a dose-effect relationship with work years.The most common affected parts are neck,lower back and right shoulder,right hand/wrist,and right forearm/elbow

关 键 词：超声医师 工作相关肌肉骨骼疾患 医院 患病率 潜在类别分析 模式 

分 类 号：R135.99[医药卫生—劳动卫生]