Cohen Steven P, Griffith Scott, Larkin Thomas M, Villena Felipe, Larkin Ralph
*Department of Anesthesiology and Critical Care Medicine, Johns Hopkins Medical Institutions, Baltimore; †Department of Anesthesiology, Uniformed Services University of the Health Sciences, Bethesda, Maryland; ‡Department of Anesthesiology, Walter Reed Army Medical Center, Washington, DC; §Pain Management Center, Landstuhl Regional Army Medical Center, Landstuhl, Germany; and ¶John Jay College of Criminal Justice of the City University of New York.
Anesth Analg. 2005 Oct;101(4):1098-1103. doi: 10.1213/01.ane.0000169332.45209.cf.
In recent military conflicts the major source of soldier attrition has not been battle injuries but more mundane causes similar to those encountered in civilian life. In an effort to determine the pain conditions affecting soldiers during wartime, we conducted an observational study among 162 soldiers medically evacuated from Operation Iraqi Freedom who were referred to 2 large pain treatment centers located outside the theaters of combat. Fifty-three percent of soldiers presented with either radicular (n = 49) or axial (n = 37) low back pain, with lumbar herniated disk being the most frequently diagnosed condition (24%). The two most implicated etiologies were exacerbation of a previous pain condition treated with surgery (15%) and motor vehicle accidents(12%). Only 17% of patients were injured during battle. Seventy-two percent of soldiers received at least one nerve block/injection, the most common of which was lumbar epidural steroid administration (22%). Nonsteroidal antiinflammatory drugs were prescribed to 56% of patients, opioids to 49%, and some form of alternative therapy to 17%. Among the 49 patients in whom data were available, only 2% returned to combat duty in Iraq. With the exception of battle-related injuries, the pain conditions suffered during modern warfare seem to be similar to those encountered in civilian pain clinics. To improve the return-to-duty rate, better preventive measures and more aggressive treatment conducted in forward-deployed medical units are recommended.
We conducted an observational study at two large military pain treatment centers among soldiers injured in Operation Iraqi Freedom. Fifty-three percent of soldiers presented with low back pain, with lumbar herniated disk being the most common diagnosis. Only 2% of patients returned to combat duty in Iraq. To improve the return-to-duty rate, better preventive measures and more aggressive treatment in forward-deployed medical units are recommended.
在最近的军事冲突中，士兵减员的主要原因并非战斗受伤，而是与平民生活中类似的更为平常的原因。为了确定战时影响士兵的疼痛状况，我们对从伊拉克自由行动中被医疗后送的162名士兵进行了一项观察性研究，这些士兵被转至位于战区外的两家大型疼痛治疗中心。53%的士兵患有神经根性（n = 49）或轴性（n = 37）下腰痛，腰椎间盘突出是最常被诊断出的病症（24%）。两个最主要的病因是既往接受手术治疗的疼痛病症加重（15%）和机动车事故（12%）。只有17%的患者在战斗中受伤。72%的士兵接受了至少一次神经阻滞/注射，其中最常见的是腰椎硬膜外类固醇注射（22%）。56%的患者被开了非甾体抗炎药，49%的患者使用了阿片类药物，17%的患者接受了某种形式的替代疗法。在有数据可查的49名患者中，只有2%返回伊拉克继续执行战斗任务。除了与战斗相关的损伤外，现代战争期间所遭受的疼痛状况似乎与平民疼痛诊所中遇到的情况相似。为提高重返岗位率，建议在前沿部署的医疗单位采取更好的预防措施并进行更积极的治疗。
我们在两家大型军事疼痛治疗中心对在伊拉克自由行动中受伤的士兵进行了一项观察性研究。53%的士兵患有下腰痛，腰椎间盘突出是最常见的诊断。只有2%的患者返回伊拉克继续执行战斗任务。为提高重返岗位率，建议在前沿部署的医疗单位采取更好的预防措施并进行更积极的治疗。
