腰椎间盘突出症的危险因素分析
|
摘要
目的探讨腰椎间盘突出症发病的主要危险因素,为制定腰椎间盘突出症的一级预防措施提供科学依据,指导腰椎间盘突出症的防治及护理。方法随机选取2015年1月~2016年6月在我科住院的200例腰椎间盘突出症患者(病例组),非腰椎间盘突出症患者200例(对照组),共400例作为调查对象。采用调查问卷的方式进行研究,包括家族史、体重指数、职业类型、单一姿势每日持续时间、腰椎负荷等。结果病例组腰椎间盘突出症的家族史为39.5%,对照组为6.0%,差异有统计学意义(P<0.01);病例组体重指数≥24 kg/m2的占72%,对照组占48%,差异有统计学意义(P<0.05);病例组患者脑力劳动、轻体力劳动、中体力劳动、重体力劳动所占比例分别为28.5%、15.5%、15.0%、41.0%,对照组患者脑力劳动、轻体力劳动、中体力劳动、重体力劳动所占比例分别为30.0%、25.5%、23.5%、21.0%,差异有统计学意义(P<0.01);病例组患者单一姿势每日持续时间>4 h的占56.5%,对照组患者单一姿势每日持续时间>4 h的占36.0%,差异有统计学意义(P<0.01);病例组腰椎负荷负荷>35 kg有36.0%,对照组腰椎负荷负荷>35 kg有16.5%,差异有统计学意义(P<0.01)。结论腰椎间盘突出症患者的家族史、体重指数均高于非腰椎间盘突出症患者,职业类型、单一姿势每日持续时间、腰椎负荷均会增加患腰椎间盘突出症风险,说明家族史、肥胖、职业类型、单一姿势每日持续时间、腰椎负荷均是腰椎间盘突出症的危险因素。
Objective To estimate the risk factors of lumbar disc herniation,and to provide scientific evidence for prevention from lumbar disc herniation,and to guide the prevention and nursing of lumbar disc herniation.Methods Patients of lumbar disc herniation randomly from January 2015 to June 2016 hospitalized in our department were selected,there were 200 cases in case group,and 200 cases in control group,totally 400 cases as the research object.With the method of questionnaire research,including family history,body mass index,professional type,single posture daily load duration,lumbar spine.Results The results of univariate analysis showed that family history of lumbar disc herniation cased out39.5%,while control group was 6.0%,comparing the two groups,the difference was statistically significant(P<0.01).There were 72% cases in cases group whose BMI≥24 kg/m2,while there were 48% in control group,comparing the two groups,the difference was statistically significant(P <0.05).Cases patients with mental labour,light manual labor,proportion of manual labor,hard physical labor were 28.5%,15.5%,15.0%,41.0%,while the proportion of control group were 30.0%,25.5%,23.5%,21.0%, comparing the two groups,the difference was statistically significant(P<0.01).Cases of patients with single posture daily duration more than 4 hours was 56.5%,while the control group is 36.0%,comparing the two groups,the difference was statistically significant(P<0.05).Cases lumbar more than 35 kg,the cases group was 36.0%,while the control group was 16.5%, comparing the two groups,the difference was statistically significant(P <0.01).Conclusion Family history,body mass index in patients with lumbar disc herniation patients were higher than in the lumbar intervertebral disc protrusion,professional type,single posture daily duration,lumbar load will increase the risk of lumbar intervertebral disc herniation.Specification,family history,obesity,professional type,single posture daily load duration,lumbar spine are the risk factors of lumbar disc herniation.
Objective To estimate the risk factors of lumbar disc herniation,and to provide scientific evidence for prevention from lumbar disc herniation,and to guide the prevention and nursing of lumbar disc herniation.Methods Patients of lumbar disc herniation randomly from January 2015 to June 2016 hospitalized in our department were selected,there were 200 cases in case group,and 200 cases in control group,totally 400 cases as the research object.With the method of questionnaire research,including family history,body mass index,professional type,single posture daily load duration,lumbar spine.Results The results of univariate analysis showed that family history of lumbar disc herniation cased out39.5%,while control group was 6.0%,comparing the two groups,the difference was statistically significant(P<0.01).There were 72% cases in cases group whose BMI≥24 kg/m2,while there were 48% in control group,comparing the two groups,the difference was statistically significant(P <0.05).Cases patients with mental labour,light manual labor,proportion of manual labor,hard physical labor were 28.5%,15.5%,15.0%,41.0%,while the proportion of control group were 30.0%,25.5%,23.5%,21.0%, comparing the two groups,the difference was statistically significant(P<0.01).Cases of patients with single posture daily duration more than 4 hours was 56.5%,while the control group is 36.0%,comparing the two groups,the difference was statistically significant(P<0.05).Cases lumbar more than 35 kg,the cases group was 36.0%,while the control group was 16.5%, comparing the two groups,the difference was statistically significant(P <0.01).Conclusion Family history,body mass index in patients with lumbar disc herniation patients were higher than in the lumbar intervertebral disc protrusion,professional type,single posture daily duration,lumbar load will increase the risk of lumbar intervertebral disc herniation.Specification,family history,obesity,professional type,single posture daily load duration,lumbar spine are the risk factors of lumbar disc herniation.
引文
[1]李盛华,孙凤歧,宋敏.阶梯疗法治疗腰椎间盘突出症的意义[J].中国中医急症,2012,21(4):591.
[2]邓强,李盛华,杨宏武,等.2009年度甘肃省中医院骨科住院患者(兰州市居民)病种调查分析[J].甘肃中医,2010,23(6):62-64.
[3]Peng BG.Pathophysiology,diagnosis,and treatment of discogeniclow back pain[J].World J Orthop,2013,4(2):42-52.
[4]侯明,朱智奇,唐向阳,等.CT影响对腰椎间盘突出症手术前后的评估[J].中国CT和MRI杂志,2012,10(1):14-16.
[5]薛力,查莉,李康仁,等.成都市第三人民医院骨科2009年住院患者疾病及费用构成现状调查[J].中国循证医学杂,2012,12(11):1296-1301.
[6]吴在德,吴肇汉.外科学[M].3版.北京:人民卫生出版社,2003:875.
[7]杨明王,崔松玉,王羚.青少年腰椎间盘突出症的预防[J].护理研究,2000,14(5):201.
[8]李冬梅,谢先琼.腰椎间盘突出症术后康复指导及护理干预效果观察[J].中国医学创新,2013,10(30):51-52.
[9]Battle MC,Videman T,Parent E.Lumbar disc degeneration:epidemiology and genetic influences[J].Spine,2004,29(23):2679-2690.
[10]唐颖,袁寒艳,王子平,等.腰椎间盘退变危险因素的病例-对照研究[J].环境与职业医学,2006,23(3):201.
[11]王琦,朱燕波,吴玉娥,等.肥胖、超重与正常体质量高血压患者的中医体质类型分布特点比较研究[J].中华中医药杂志,2011,26(8):676-679.
[12]李明平.肥胖症与腰椎间盘突出症的相关联系[J].疾病监测与控制,2010,4(9):546-547.
[13]曾佳兴.腰椎间盘突出发病机制的研究进展[J].医学综述,2012,18(11):1723-1726.
[14]贾乐生,赤仁杰,夏凡,等.沈阳西部地区腰椎间盘突出症患病危险因素调查[J].中国民康医学,2011,23(2):155-156.
[15]Goupille H,Jayson M,Valat J,et al.Matrix metalloproteinases:the clue to intergertbral disc[J].Spine,1998,23(14):1612-1626.
[2]邓强,李盛华,杨宏武,等.2009年度甘肃省中医院骨科住院患者(兰州市居民)病种调查分析[J].甘肃中医,2010,23(6):62-64.
[3]Peng BG.Pathophysiology,diagnosis,and treatment of discogeniclow back pain[J].World J Orthop,2013,4(2):42-52.
[4]侯明,朱智奇,唐向阳,等.CT影响对腰椎间盘突出症手术前后的评估[J].中国CT和MRI杂志,2012,10(1):14-16.
[5]薛力,查莉,李康仁,等.成都市第三人民医院骨科2009年住院患者疾病及费用构成现状调查[J].中国循证医学杂,2012,12(11):1296-1301.
[6]吴在德,吴肇汉.外科学[M].3版.北京:人民卫生出版社,2003:875.
[7]杨明王,崔松玉,王羚.青少年腰椎间盘突出症的预防[J].护理研究,2000,14(5):201.
[8]李冬梅,谢先琼.腰椎间盘突出症术后康复指导及护理干预效果观察[J].中国医学创新,2013,10(30):51-52.
[9]Battle MC,Videman T,Parent E.Lumbar disc degeneration:epidemiology and genetic influences[J].Spine,2004,29(23):2679-2690.
[10]唐颖,袁寒艳,王子平,等.腰椎间盘退变危险因素的病例-对照研究[J].环境与职业医学,2006,23(3):201.
[11]王琦,朱燕波,吴玉娥,等.肥胖、超重与正常体质量高血压患者的中医体质类型分布特点比较研究[J].中华中医药杂志,2011,26(8):676-679.
[12]李明平.肥胖症与腰椎间盘突出症的相关联系[J].疾病监测与控制,2010,4(9):546-547.
[13]曾佳兴.腰椎间盘突出发病机制的研究进展[J].医学综述,2012,18(11):1723-1726.
[14]贾乐生,赤仁杰,夏凡,等.沈阳西部地区腰椎间盘突出症患病危险因素调查[J].中国民康医学,2011,23(2):155-156.
[15]Goupille H,Jayson M,Valat J,et al.Matrix metalloproteinases:the clue to intergertbral disc[J].Spine,1998,23(14):1612-1626.