陆军新兵训练应力性骨损伤调查与相关因素分析  

A survey and correlative factors analysis of bone stress injury in army recruits training

作　　者：徐健 于健 许金芳 吴毅东 于康康 李中耀 甄平 董晨辉[1] 李春宝 XU Jian;YU Jian;XU Jin-fang;WU Yi-dong;YU Kang-kang;LI Zhong-yao;ZHEN Ping;DONG Chen-hui;LI Chun-bao(Department of Sports Medicine,940 thHospital,Joint Logistic Support Force of PLA,Lanzhou 730050,China;The Second Clinical College,Lanzhou University,Lanzhou 730000,China;Department of Military Health Statistics,Naval Medical University,Shanghai 200435,China;Department of Orthopedic Medi-cine,The Fourth Medical Center of PLA General Hospital,Beijing 100853,China)

机构地区：[1]解放军联勤保障部队第九四〇医院运动医学科,甘肃兰州730050 [2]兰州大学第二临床医学院,甘肃兰州730000 [3]解放军海军军医大学军队卫生统计学教研室,上海200435 [4]解放军总医院第四医学中心骨科医学部,北京100853

出　　处：《中国矫形外科杂志》2024年第12期1057-1062,共6页Orthopedic Journal of China

基　　金：军委科技委专项项目(编号:223-CXCY-M113-01-17-01);全军后勤科研项目(编号:CLB21J035);军队科研项目(编号2021yxky020);重大需求培育资助项目(编号:31920220108)。

摘　　要：[目的]探索陆军某基地新兵应力性骨损伤(bone stress injuries,BSI)的发生特征和风险因素。[方法]随机抽取2021—2023年陆军某新训基地入伍新兵,通过问卷调查和巡诊方式进行数据收集,总结分析其流行病学特征。[结果]共收集有效问卷11627份,其中1626名新兵被诊断为应力性骨损伤,发生率为14.0%,其中胫骨损伤1010例,占62.1%。是否损伤的单因素比较显示,损伤组的女性占比[例,男/女,(1583/43)vs(9981/190),P=0.047]、年龄[(21.3±2.4)岁vs(21.1±2.0)岁,P=0.002]、BMI[(22.6±2.5)kg/m^(2)vs(22.4±2.3)kg/m^(2),P=0.004]、吸烟率[例,有/无,(679/947)vs(3625/6379),P<0.001]、PSQI评分[(4.6±2.8)vs(2.3±2.3),P<0.001]、入伍前运动损伤[例,有/无,(173/1453)vs(618/9383),P<0.001]均显著高于未损伤组(P<0.05);未损伤组的饮食[例,良好/较好/差,(5048/4033/920)vs(533/829/264),P<0.001]、睡眠[例,很好/较好/一般/差,(6063/2782/1026/130)vs(724/575/271/56),P<0.001]、入伍前运动习惯[例,从不/偶尔/经常,(673/2611/6717)vs(259/577/790),P<0.001]、足弓形态[例,正常/异常,(8938/1063)vs(1394/232),P<0.001]、韧带松弛评分[例,<3/≥3,(8397/1604)vs(1320/306),P=0.005]、3000 m跑[例,优/良/可,(1140/4756/4105)vs(127/576/923),P<0.001]和仰卧起坐成绩[例,优/良/可/差,(2473/3604/3479/445)vs(320/522/644/140),P<0.001]显著优于损伤组。二元多因素逻辑回归分析表明:饮食良好(OR=0.786,P=0.012)、入伍前无运动损伤(OR=0.747,P<0.001)、男性(OR=0.630,P=0.017)是BSI发生的保护因素;3000 m跑成绩差(OR=1.460,P<0.001)、入伍前无运动习惯(OR=1.440,P<0.001)、PSQI评分高(OR=1.335,P<0.001)、异常足弓(OR=1.176,P=0.011)是损伤发生的独立危险因素。[结论]陆军某部新兵应力性骨损伤发生率为14.0%,其中胫骨发生率最高;性别、饮食质量、入伍前运动损伤、入伍前运动习惯、PSQI评分、足弓形态和3000 m跑成绩可作为应力性骨损伤的风险评估指标。[Objective]To explore the occurrence characteristics and risk factors of bone stress injuries(BSI)in recruits of an army training base.[Methods]The recruits were randomly selected from a training base of the army from 2021 to 2023.The data were collected through questionnaire survey and inspection,and their epidemiological characteristics were summarized and analyzed.[Results]A total of 11627 valid questionnaires were collected,among which 1626 recruits were diagnosed with BSI(14.0%),including 1010 cases of tibia in⁃jury,accounted for 62.1%.As results of univariate comparison,the injured group proved significantly higher than the uninjured group in terms of the proportion of female[n,male/female,(1583/43)vs(9981/190),P=0.047],age[(21.3±2.4)y vs(21.1±2.0)y,P=0.002],BMI[(22.6±2.5)kg/m^(2) vs(22.4±2.3)kg/m^(2),P=0.004],smoking[n,yes/no,(679/947)vs(3625/6379),P<0.001],PSQI score[(4.6±2.8)vs(2.3±2.3),P<0.001]and previous sports injury before joining the army[n,yes/no,(173/1453)vs(618/9383),P<0.001],while the former was infe⁃rior to the latter in terms of diet[n,good/fair/poor,(5048/4033/920)vs(533/829/264),P<0.001],sleep[n,excellent/good/fair/poor,(6063/2782/1026/130)vs(724/575/271/56),P<0.001],exercise habits[n,never/occasionally/often,(673/2611/6717)vs(259/577/790),P<0.001],foot arch[n,normal/abnormal,(8938/1063)vs(1394/232),P<0.001],ligament relaxation score[n,<3/≥3,(8397/1604)vs(1320/306),P=0.005],scores of 3000 m running[n,excellent/good/fair,(1140/4756/4105)vs(127/576/923),P<0.001]and sit-ups[n,excellent/good/fair/poor,(2473/3604/3479/445)vs(320/522/644/140),P<0.001].Regarding binary multivariate logistic regression analysis,male(OR=0.630,P<0.05),good diet(OR=0.786,P<0.05),non-injury before enlistment(OR=0.747,P<0.05)were the protective factor of BSI oc⁃currence,whereas higher PSQI score(OR=1.335,P<0.05),less exercise before joining the army(OR=1.440,P<0.05),abnormal foot arch(OR=1.176,P<0.05)and poor performance at 3000 m running(OR=1.460,P<0.05)were the independent risk factor for the injury.[Con

关 键 词：应力性骨损伤 流行病学调查 危险因素 新兵训练 

分 类 号：R68[医药卫生—骨科学]