CAJ | 학술논문

目的：应用便携式彩超高频探头观测新兵军训期间双侧胫骨前内侧骨膜厚度的动态变化，从而了解高频超声对应力性骨损伤的早期诊断价值。方法2012年12月~2013年4月，随机抽取300名右利手新兵作为研究对象，开训前均无下肢疼痛等不适症状。于开始训练前、训练1个月后及3个月后分别应用便携式彩超高频探头逐一测量双侧胫骨前内侧骨膜厚度。自胫骨结节至内踝之间分为上、中、下三等分，测量上等分和下等分，记录测量数据并进行对比。结果训练1个月后及3个月后双侧胫骨前内侧骨膜平均厚度均较开始训练前明显增厚（P ﹤0.05）；训练1个月后及3个月后双侧胫骨前内侧骨膜平均厚度差异不显著（P ﹥0.05）。以训练1个月后双侧胫骨前内侧骨膜增厚为著；以右侧胫骨前内侧骨膜上等分增厚为著。本组共有15例发生胫骨应力性损伤，其中右侧12例、左侧3例，上等分11例、下等分4例。应力性骨损伤的程度随着军训时间延长或强度加大而逐渐加重。结论便携式彩超高频探头对软组织病变具有良好的分辨能力，能及时准确地观测胫骨骨膜厚度的变化，可作为新兵军训阶段下肢应力性骨损伤的首选检查和诊断方法。右侧胫骨上等分为应力性骨损伤的高发部位。
목적：응용편휴식채초고빈탐두관측신병군훈기간쌍측경골전내측골막후도적동태변화，종이료해고빈초성대응력성골손상적조기진단개치。방법2012년12월~2013년4월，수궤추취300명우리수신병작위연구대상，개훈전균무하지동통등불괄증상。우개시훈련전、훈련1개월후급3개월후분별응용편휴식채초고빈탐두축일측량쌍측경골전내측골막후도。자경골결절지내과지간분위상、중、하삼등분，측량상등분화하등분，기록측량수거병진행대비。결과훈련1개월후급3개월후쌍측경골전내측골막평균후도균교개시훈련전명현증후（P ﹤0.05）；훈련1개월후급3개월후쌍측경골전내측골막평균후도차이불현저（P ﹥0.05）。이훈련1개월후쌍측경골전내측골막증후위저；이우측경골전내측골막상등분증후위저。본조공유15례발생경골응력성손상，기중우측12례、좌측3례，상등분11례、하등분4례。응력성골손상적정도수착군훈시간연장혹강도가대이축점가중。결론편휴식채초고빈탐두대연조직병변구유량호적분변능력，능급시준학지관측경골골막후도적변화，가작위신병군훈계단하지응력성골손상적수선검사화진단방법。우측경골상등분위응력성골손상적고발부위。
Objective To observe the thickness of bilateral anteriormedial tibial periosteum during recruits mili-tary training using portable ultrasound frequency probe in order to explore early diagnostic value of high frequency ul-trasound to stress injury. Methods 300 recruits were randomly selected for the study from Dec. 2012 to Apr. 2013,all of whom had no leg pain before training. The thickness of bilateral anteriormedial tibial periosteum was measured by portable ultrasound frequency probe at the beginning of training,one month and three months after training. Upper, middle and lower portion were divided from tibial tubercle to malleolus medialis. Upper and lower portion were meas-ured,recorded and compared. Results Bilateral anteriormedial tibial periosteum was significantly thicker one month and three months after training than that in the beginning(P ﹤ 0. 05). There was no significant difference in bilateral anteriormedial tibial periosteum one month and three month after training(P ﹥ 0. 05). Bilateral anteriormedial tibial periosteum and upper portion of offside anteriormedial tibial periosteum were significantly thicker after one month of training. A total of 15 cases of stress injury were included in the group with 12 cases of right,3 cases of left,11 cases of upper,4 cases of lower. The extent of bone stress injury gradually increased with prolonged military training. Conclu-sion Portable ultrasound frequency probe is useful for soft tissue lesions,which can observe the thickness of tibial periosteum accurately,and can be used as preferred examination and diagnosis for bone stress injury of the lower limbs in recruits military training. The upper portion of offside tibia is high incidence area of stress injury.