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Article(id=1320434451381866706, tenantId=1146029695717560320, journalId=1319373162502258839, issueId=1320434416447500876, articleNumber=null, orderNo=null, doi=10.16016/j.2097-0927.202511057, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1761321600000, receivedDateStr=2025-10-25, revisedDate=1764432000000, revisedDateStr=2025-11-30, acceptedDate=null, acceptedDateStr=null, onlineDate=1792745705695, onlineDateStr=2026-10-23, pubDate=1768406400000, pubDateStr=2026-01-15, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1792745705695, onlineIssueDateStr=2026-10-23, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1792745705695, creator=13701087609, updateTime=1792745705695, updator=13701087609, issue=Issue{id=1320434416447500876, tenantId=1146029695717560320, journalId=1319373162502258839, year='2026', volume='48', issue='1', pageStart='1', pageEnd='106', issueExtLink='null', onlineDate='null', pubDate='1768406400000', pubDateStr='2026-01-15', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1792745697366, creator='13701087609', updateTime=1792749679774, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1320451119940227660, tenantId=1146029695717560320, journalId=1319373162502258839, issueId=1320434416447500876, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1320451119940227661, tenantId=1146029695717560320, journalId=1319373162502258839, issueId=1320434416447500876, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=94, endPage=99, ext={EN=ArticleExt(id=1320434453294469333, articleId=1320434451381866706, tenantId=1146029695717560320, journalId=1319373162502258839, language=EN, title=Epidemiological survey on functional constipation among military personnel stationed in high-altitude special environments and formulation of its comprehensive prevention and control strategies, columnId=1320434453051199700, journalTitle=Journal of Army Medical University, columnName=Think Tank for Public Health, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate the incidence of functional constipation (FC) in troops stationed at plateau, to explore the rules and features of FC occurring in high altitude, and to analyze related factors and develop prevention and treatment measures.

Methods

A survey was carried out during May and August 2024 with Rome Ⅲ diagnostic criteria, symptom checklist-90 (SCL-90) and self-designed questionnaires on the soldiers who had been stationed in the highland area (5 100 m) for more than 6 months subjected with stratified cluster random sampling. A total of 770 questionnaires were distributed, and 765 ones were recovered. These questionnaires mainly included a retrospective survey on constipation symptoms, and 9 related factors were evaluated. Univariate and multivariate logistic regression analyses were applied to identify the independent influencing factors for FC.

Results

Totally 765 valid questionnaires were collected, and the incidence of FC was 15.8%. Logistic regression analysis showed that lack of dietary fiber (OR=4.347, 95%CI: 2.749 to 6.873), anxiety (OR=3.625, 95%CI: 2.279 to 5.766), frequent suppression of defecation (OR=2.869, 95%CI: 1.846 to 4.458), insufficient oxygen intake (OR=2.664, 95%CI: 1.712 to 4.145) and lack of exercise (OR=2.346, 95%CI: 1.429 to 3.849) were the potential risk factors for FC (P<0.01).

Conclusion

The incidence of FC is 15.8% among high-altitude officers and soldiers, and its main risk factors are lack of dietary fiber, anxiety, frequent restraint of defecation, insufficient oxygen intake, and lack of exercise. Countermeasures High priority should be given to the issue of FC among plateau-stationed troops. Following comprehensive interventions are recommended: ① Improve environmental and managerial conditions by optimizing accommodation facilities, daily schedules, and ensuring adequate time of oxygen supply; ② Promote healthy behaviors through dietary restructuring, increased fiber and water intake, scientifically planned physical activities, and avoidance of prolonged sitting and deliberate suppression of bowel movements; ③ Strengthen psychological support by implementing mental health counseling to alleviate anxiety; ④ Standardize medical interventions with appropriate pharmacological assistance when necessary. Through multidimensional and systematic health management, the incidence of functional constipation can be effectively reduced, thereby safeguarding both the physical and mental well-being of the troops and maintaining combat readiness.

, authors=Weilong DOU, Hao ZENG, Zhiyong SUN, authorsList=Weilong DOU, Hao ZENG, Zhiyong SUN, authorCompany=null, correspAuthors=Weilong DOU, authorNote=null, correspAuthorsNote=null, copyrightStatement=© 2026 Journal of Army Medical University, copyrightOwner=Editorial Office of Journal of Army Medical University, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1320434453814563033, articleId=1320434451381866706, tenantId=1146029695717560320, journalId=1319373162502258839, language=CN, title=高海拔特殊环境驻地官兵功能性便秘的流行病学调查与综合防控策略构建, columnId=1320434453520961751, journalTitle=陆军军医大学学报, columnName=论著·公共卫生智库, runingTitle=null, highlight=null, articleAbstract=
目的

调查高原部队官兵功能性便秘（functional constipation，FC）的发病状况，探讨机体在高原发生功能性便秘的规律及特点，分析相关因素并制定防治措施。

方法

本研究于2024年5—8月，采用分层整群随机抽样方法，对进入海拔5 100 m高原、驻守时间超过6个月的官兵开展问卷调查。共发放问卷770份，有效回收765份。问卷内容主要包括便秘症状回顾性调查以及9项潜在相关因素的评估。数据分析采用单因素分析与多因素Logistic回归分析，以识别功能性便秘的独立影响因素。

结果

共回收765份有效问卷，FC患病率为15.8%，Logistic回归分析表明，缺乏膳食纤维（OR=4.347，95%CI： 2.749~6.873）、心情焦虑（OR=3.625，95%CI：2.279~5.766）、经常克制排便（OR=2.869，95%CI： 1.846~4.458）、吸氧不足（OR=2.664，95%CI：1.712~4.145）和缺乏运动（OR=2.346，95%CI： 1.429~3.849）为FC可能性的危险因素，各因素P值均小于0.01。

结论

高原官兵FC的患病率达15.8%，主要危险因素为：缺乏膳食纤维、心情焦虑、经常克制排便、吸氧不足和缺乏运动。对策　高原官兵功能性便秘问题应予以高度重视。建议采取以下综合干预措施：一是改善环境与管理，优化住宿条件、作息安排和吸氧时间；二是促进健康行为，调整膳食结构、增加纤维摄入与饮水，科学安排体能活动，避免久坐与刻意抑制排便；三是加强心理支持，开展心理健康疏导，缓解焦虑情绪；四是规范医疗干预，在必要时合理使用药物辅助治疗。通过多维度、系统性的健康管理，切实降低功能性便秘发生率，保障官兵身心健康与部队战斗力。

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窦维龙，E-mail：
DOU Weilong E-mail：
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Clin J Med Off， 2021， 49（4）： 371-373., articleTitle=Analysis of the effect of Bifid Triple Viable Capsules combined with Qirong Runchang oral liquid on high altitude functional constipation under severe cold condition, refAbstract=null)], funds=null, companyList=[AuthorCompany(id=1320434454145913050, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320434451381866706, xref=1, ext=[AuthorCompanyExt(id=1320434454179467483, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320434451381866706, companyId=1320434454145913050, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1Department of General Surgery， No. 946 Hospital of PLA Army， Yining， Xinjiang， China), AuthorCompanyExt(id=1320434454187856092, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320434451381866706, companyId=1320434454145913050, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1中国人民解放军陆军第九四六医院普通外科，新疆伊宁)])], figs=[ArticleFig(id=1320434457941758196, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320434451381866706, language=EN, label=Table 1, caption=

Incidence rate of functional constipation in different age groups

, figureFileSmall=null, figureFileBig=null, tableContent=
AgeTotal participantsNumber of patientsIncidence rate/%
Total76512115.8
≤2020315.0
21~253855313.8
26~302543915.4
31~35872023.0
≥3619631.6
), ArticleFig(id=1320434458021449973, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320434451381866706, language=CN, label=表1, caption=

各年龄段高原部队官兵功能性便秘发病率

, figureFileSmall=null, figureFileBig=null, tableContent=
AgeTotal participantsNumber of patientsIncidence rate/%
Total76512115.8
≤2020315.0
21~253855313.8
26~302543915.4
31~35872023.0
≥3619631.6
), ArticleFig(id=1320434458105336054, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320434451381866706, language=EN, label=Table 2, caption=

Univariate logistic regression analysis of functional constipation

, figureFileSmall=null, figureFileBig=null, tableContent=
Risk factorβSEWaldPOR（95%CI）
Lack of dietary fiber1.3210.21039.566<0.0013.747（2.483~5.655）
Anxiety1.1970.21231.955<0.0013.309（2.185~5.011）
Frequent suppression of defecation1.0440.20625.576<0.0012.840（1.895~4.256）
Insufficient oxygen intake0.9900.20722.838<0.0012.690（1.793~4.037）
Lack of exercise0.8300.11513.016<0.0012.293（1.461~3.598）
Spicy and irritating diet0.2110.2101.0160.3141.235（0.819~1.863）
Sleep deprivation0.1520.2230.4610.4971.164（0.751~1.804）
Smoking0.0240.2270.0120.9141.025（0.657~1.598）
High-fat diet-0.0950.2220.1830.6690.910（0.589~1.405）
), ArticleFig(id=1320434458394743031, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320434451381866706, language=CN, label=表2, caption=

高原部队官兵功能性便秘发生的单因素Logistic回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
Risk factorβSEWaldPOR（95%CI）
Lack of dietary fiber1.3210.21039.566<0.0013.747（2.483~5.655）
Anxiety1.1970.21231.955<0.0013.309（2.185~5.011）
Frequent suppression of defecation1.0440.20625.576<0.0012.840（1.895~4.256）
Insufficient oxygen intake0.9900.20722.838<0.0012.690（1.793~4.037）
Lack of exercise0.8300.11513.016<0.0012.293（1.461~3.598）
Spicy and irritating diet0.2110.2101.0160.3141.235（0.819~1.863）
Sleep deprivation0.1520.2230.4610.4971.164（0.751~1.804）
Smoking0.0240.2270.0120.9141.025（0.657~1.598）
High-fat diet-0.0950.2220.1830.6690.910（0.589~1.405）
), ArticleFig(id=1320434458466046200, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320434451381866706, language=EN, label=Table 3, caption=

Multivariate logistic regression analysis of the main risk factors of functional constipation

, figureFileSmall=null, figureFileBig=null, tableContent=
Risk factorβSEWaldPOR（95%CI）
Lack of dietary fiber1.4690.23439.515<0.014.347（2.749~6.873）
Anxiety1.2880.23729.581<0.013.625（2.279~5.766）
Frequent suppression of defecation1.0540.22521.943<0.012.869（1.846~4.458）
Insufficient oxygen intake0.9800.22618.855<0.012.664（1.712~4.145）
Lack of exercise0.8530.25311.385<0.012.346（1.429~3.849）
), ArticleFig(id=1320434458738675961, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320434451381866706, language=CN, label=表3, caption=

高原部队官兵功能性便秘发生的多因素Logistic回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
Risk factorβSEWaldPOR（95%CI）
Lack of dietary fiber1.4690.23439.515<0.014.347（2.749~6.873）
Anxiety1.2880.23729.581<0.013.625（2.279~5.766）
Frequent suppression of defecation1.0540.22521.943<0.012.869（1.846~4.458）
Insufficient oxygen intake0.9800.22618.855<0.012.664（1.712~4.145）
Lack of exercise0.8530.25311.385<0.012.346（1.429~3.849）
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高海拔特殊环境驻地官兵功能性便秘的流行病学调查与综合防控策略构建
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窦维龙 , 曾昊 , 孙智勇
陆军军医大学学报 | 论著·公共卫生智库 2026,48(1): 94-99
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陆军军医大学学报 |论著·公共卫生智库 2026 , 48 (1) : 94 -99
高海拔特殊环境驻地官兵功能性便秘的流行病学调查与综合防控策略构建
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窦维龙 , 曾昊, 孙智勇
作者信息
  • 1中国人民解放军陆军第九四六医院普通外科，新疆伊宁
通讯作者:
窦维龙，E-mail：
DOU Weilong E-mail：
Epidemiological survey on functional constipation among military personnel stationed in high-altitude special environments and formulation of its comprehensive prevention and control strategies
Weilong DOU , Hao ZENG, Zhiyong SUN
Affiliations
  • 1Department of General Surgery， No. 946 Hospital of PLA Army， Yining， Xinjiang， China
出版时间: 2026-01-15 doi: 10.16016/j.2097-0927.202511057
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摘要
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目的

调查高原部队官兵功能性便秘（functional constipation，FC）的发病状况，探讨机体在高原发生功能性便秘的规律及特点，分析相关因素并制定防治措施。

方法

本研究于2024年5—8月，采用分层整群随机抽样方法，对进入海拔5 100 m高原、驻守时间超过6个月的官兵开展问卷调查。共发放问卷770份，有效回收765份。问卷内容主要包括便秘症状回顾性调查以及9项潜在相关因素的评估。数据分析采用单因素分析与多因素Logistic回归分析，以识别功能性便秘的独立影响因素。

结果

共回收765份有效问卷，FC患病率为15.8%，Logistic回归分析表明，缺乏膳食纤维（OR=4.347，95%CI： 2.749~6.873）、心情焦虑（OR=3.625，95%CI：2.279~5.766）、经常克制排便（OR=2.869，95%CI： 1.846~4.458）、吸氧不足（OR=2.664，95%CI：1.712~4.145）和缺乏运动（OR=2.346，95%CI： 1.429~3.849）为FC可能性的危险因素，各因素P值均小于0.01。

结论

高原官兵FC的患病率达15.8%，主要危险因素为：缺乏膳食纤维、心情焦虑、经常克制排便、吸氧不足和缺乏运动。对策　高原官兵功能性便秘问题应予以高度重视。建议采取以下综合干预措施：一是改善环境与管理，优化住宿条件、作息安排和吸氧时间；二是促进健康行为，调整膳食结构、增加纤维摄入与饮水，科学安排体能活动，避免久坐与刻意抑制排便；三是加强心理支持，开展心理健康疏导，缓解焦虑情绪；四是规范医疗干预，在必要时合理使用药物辅助治疗。通过多维度、系统性的健康管理，切实降低功能性便秘发生率，保障官兵身心健康与部队战斗力。

军事医学  /  高原  /  便秘
Objective

To investigate the incidence of functional constipation (FC) in troops stationed at plateau, to explore the rules and features of FC occurring in high altitude, and to analyze related factors and develop prevention and treatment measures.

Methods

A survey was carried out during May and August 2024 with Rome Ⅲ diagnostic criteria, symptom checklist-90 (SCL-90) and self-designed questionnaires on the soldiers who had been stationed in the highland area (5 100 m) for more than 6 months subjected with stratified cluster random sampling. A total of 770 questionnaires were distributed, and 765 ones were recovered. These questionnaires mainly included a retrospective survey on constipation symptoms, and 9 related factors were evaluated. Univariate and multivariate logistic regression analyses were applied to identify the independent influencing factors for FC.

Results

Totally 765 valid questionnaires were collected, and the incidence of FC was 15.8%. Logistic regression analysis showed that lack of dietary fiber (OR=4.347, 95%CI: 2.749 to 6.873), anxiety (OR=3.625, 95%CI: 2.279 to 5.766), frequent suppression of defecation (OR=2.869, 95%CI: 1.846 to 4.458), insufficient oxygen intake (OR=2.664, 95%CI: 1.712 to 4.145) and lack of exercise (OR=2.346, 95%CI: 1.429 to 3.849) were the potential risk factors for FC (P<0.01).

Conclusion

The incidence of FC is 15.8% among high-altitude officers and soldiers, and its main risk factors are lack of dietary fiber, anxiety, frequent restraint of defecation, insufficient oxygen intake, and lack of exercise. Countermeasures High priority should be given to the issue of FC among plateau-stationed troops. Following comprehensive interventions are recommended: ① Improve environmental and managerial conditions by optimizing accommodation facilities, daily schedules, and ensuring adequate time of oxygen supply; ② Promote healthy behaviors through dietary restructuring, increased fiber and water intake, scientifically planned physical activities, and avoidance of prolonged sitting and deliberate suppression of bowel movements; ③ Strengthen psychological support by implementing mental health counseling to alleviate anxiety; ④ Standardize medical interventions with appropriate pharmacological assistance when necessary. Through multidimensional and systematic health management, the incidence of functional constipation can be effectively reduced, thereby safeguarding both the physical and mental well-being of the troops and maintaining combat readiness.

military medicine  /  plateau  /  constipation
窦维龙, 曾昊, 孙智勇. 高海拔特殊环境驻地官兵功能性便秘的流行病学调查与综合防控策略构建. 陆军军医大学学报, 2026 , 48 (1) : 94 -99 . DOI: 10.16016/j.2097-0927.202511057
Weilong DOU, Hao ZENG, Zhiyong SUN. Epidemiological survey on functional constipation among military personnel stationed in high-altitude special environments and formulation of its comprehensive prevention and control strategies[J]. Journal of Army Medical University, 2026 , 48 (1) : 94 -99 . DOI: 10.16016/j.2097-0927.202511057
正文
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平原个体进入高原后会因为低压缺氧等环境变化引发高原反应，其中消化道症状有反酸、腹胀、食欲减退、便秘、腹泻等。其中腹胀、反酸等症状通常在习服2周左右可逐渐减轻，但功能性便秘（functional constipation，FC）持续时间较长，对官兵身心健康和工作效率有较大影响。有研究表明急进高原4 700 m，官兵便秘发生率为78%，30 d后可降至10.4%［1］。但目前缺乏进入近5 000 m高原后长期FC及相关因素的调查研究。为研究官兵进入高原后长期FC患病率及相关因素的流行病学特点，制定合理干预措施，本研究对部分高原寒区驻训官兵进行了调查，现报告如下。
1　对象与方法
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1.1　调查对象与样本量估算
2024年5—8月，于海拔5 100 m某地域，调查进入高原时长超过6个月的官兵。采用横断面调查研究的样本量估计方法计算研究所需的样本例数。当前国内尚无海拔5 000 m地域人群慢性FC患病率报道，既往报道急进高原4 700 m官兵30 d后便秘发生率为10.4%［1］。因此本研究样本量估算时总体患病率取值P=10%，α=0.05，容许误差定为0.03。对总体率估计的样本量计算公式如下：n=1.962×0.1×（1-0.1）/0.032≈385。考虑被调查者因任务特殊性，应答率可能较低，以及本次采用分层、整群抽样方式进行，应适当扩大样本量385×2=770。以连队为最小抽样单位。均为男性，年龄19~43（26.1±4.1）岁，服役时间1~25（3.7±1.8）年。
1.2　调查方法
本研究为横断面调查。本地域共4个点位，每个点位随机抽取2个连队所有官兵纳入调查。抽取样本后，如因客观条件限制导致无法完成调查，则在同点位其他连队人员中进行随机同等置换，确保有足够的样本。填写问卷前对调查对象进行培训，调查过程现场答疑。
采用罗马Ⅲ标准流行病学调查问卷（RomeⅢ MQ）、症状自评量表（symptom checklist 90，SCL-90）以及自制调查表回顾性收集数据。内容包含被调查者的便秘症状、年龄、服役时间、工作岗位、排便习惯、饮食特点、心理因素、睡眠、吸烟、吸氧、运动情况、到高原次数、如厕条件等信息。本研究调查所涉及部队对官兵日常饮水有强制性要求，管理较为严格，官兵饮水普遍较为充分，因此饮水量信息未纳入调查研究。
1.3　诊断标准
FC诊断在问卷筛选后由专科医生面诊，逐一按照罗马Ⅲ诊断标准进行临床诊断，排除进入高原前已有便秘症状，体检发现消化系统有明确器质性疾病或其他严重的全身性疾病。心情焦虑以SCL-90量表自评160分为标准。
吸烟被定义为>1支/d且连续或累计吸烟时间>6个月。吸氧不足定义为平均每日吸氧时间<2 h或每周吸氧频次<3次。每日体能训练时间<1 h或每周体能训练<3次定义为缺乏运动。主动克制排便定义为有便意时主动有意识抑制排便次数每周>3次，且出现便意到排便时间间隔>4 h。睡眠不足定义为每日睡眠时间<6 h且持续1周以上。饮食习惯数据以被调查者主观判断为依据。辛辣刺激饮食和高脂肪饮食定义为每周食用辛辣刺激食物或高脂肪及油腻食物>3次。缺乏膳食纤维的定义为膳食纤维的摄入量低于30 g/d。以上信息均采集为二分类数据。
1.4　统计学方法
全部资料采用Excel和SPSS 29.0软件进行统计分析。率比较采用χ2检验，相关性分析采用单因素及多因素Logistic回归分析，P<0.05为差异有统计学意义。
2　结果
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2.1　高原官兵FC患病率较高
共调查770人，其中765人规范有效地完成了问卷调查表。检出FC共121例，患病率为15.8%，显著高于平原部队调查结果5.49%［2］。各年龄组患病率随年龄增长，36岁以上为31.6%（表1）。
2.2　患病率与各危险因素的关系
单因素Logistic回归分析各因素对FC发病的影响，发现缺乏膳食纤维、心情焦虑、经常克制排便、吸氧不足和缺乏运动与FC患病率不同程度相关，其中OR值最高为缺乏膳食纤维。辛辣刺激饮食、睡眠时间不足、吸烟和高脂肪饮食与便秘关系不大（表2）。在此基础上，选择OR值较高且P<0.01的变量进行多因素Logistic 回归分析，OR值由大到小排序依次为缺乏膳食纤维、心情焦虑、经常克制排便、吸氧不足和缺乏运动（表3）。
3　讨论
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3.1　高原FC发病机制
便秘的发病机制十分复杂，涉及脑-肠-菌轴、精神心理因素、胃肠自主神经系统、胃肠动力平滑肌运动功能、免疫系统等方面，同时与遗传、饮食习惯、生活环境等因素有关。有研究认为，肠神经系统结构或功能的改变会引起结肠感觉运动障碍是最可能的发病机制［3］。对于高海拔特殊环境引起便秘的生理机制目前研究较少。有研究发现，高原低压缺氧可导致胃肠道血供减少、胃肠激素变化和Cajal间质细胞（interstitial cells of Cajal，ICC）数量及结构功能的变化［4-6］，可能是导致高原便秘发生的原因。总之目前高原环境引起便秘的机制还不明确。
3.2　高原FC发病相关危险因素分析
3.2.1　缺乏膳食纤维
饮食结构与消化功能密切相关，辛辣刺激饮食、膳食纤维不足以及高脂肪饮食是便秘的危险因素［7］。SCHMIER等［8］研究发现，膳食纤维摄入量每天增加1 g，可减少1.9%的便秘患病率。膳食纤维能增加粪便体积，维持粪便性状，刺激肠道蠕动，保持肠道内的水分含量，使粪便更容易排出体外。并且膳食纤维有调节胃肠道内环境、促进有益菌的生长、维持胃酸平衡的功能。有研究显示，膳食纤维缺乏是高原高寒地区官兵便秘相关内痔发生的高风险因素，内痔会加剧排便困难，便秘的持续存在可导致肛垫区压力增大，进而影响静脉回流，导致肛垫充血、水肿，内痔加重，形成一个恶性循环［9］。部队进入高原后，部分官兵因高原腹胀消化不良等造成饮食量减少，因为基础设施限制，工作环境特殊等原因，平时饮食中新鲜水果蔬菜供应量少［10］，所以官兵饮食中膳食纤维摄入相对不足，对FC发生有一定影响。
3.2.2　心情焦虑
大量研究表明心理因素可通过多种途径造成便秘的发生。CHAN等［11］研究发现精神、心理因素可能通过肠神经系统抑制结肠蠕动，使肠道蠕动功能和内脏敏感性降低造成便秘发生。WANG等［12］研究发现，便秘患者较非便秘患者发生重度抑郁的可能性明显升高，而重度抑郁患者逐渐发生便秘的可能性高于无抑郁患者。高原驻训官兵生活条件和自然环境差，巡逻、训练等任务繁重，面临多种应激因素，精神及心理异常发生率高于平原部队，更容易引发便秘。便秘症状干扰了训练、学习、工作，引起焦虑、紧张等不良情绪又可以通过自主神经系统影响胃肠道功能，加重便秘症状，形成恶性循环。目前关于高原环境下，精神心理因素与便秘相关性的研究较少。冯旭等［13］研究发现长期军事应激状态会影响胃肠功能及内脏敏感性，使FC的患病率明显增高。
3.2.3　官兵经常克制排便
因排便反射的生理机制，晨起或早餐后为符合生理规律的排便时间。但在我们平时巡诊保障中发现，高原环境下官兵在此时间段克制便意现象明显增多。主要原因有进入高原后部队管理特点导致官兵在此特定时间段集体活动内容多、节奏快、可自由支配时间较短，部分官兵因时间紧迫，错过排便时间。同时高原环境下厕所条件有限，以室外厕所为主，因天气寒冷以及道路湿滑，且早晨或就寝前集中时间如厕导致出现排队，官兵不愿在此时间段外出如厕。本研究还发现，进入高原后因环境变化部分青年战士以往每日正常的便意减弱，且规律紊乱，使得克制便意更加容易实现。以上原因造成部分官兵无法自主选择排便时间，在合理排便时间克制排便。经常主动克制排便使直肠适应性延展扩张，肠壁神经对粪便刺激的敏感性降低，需要更多粪便集聚在直肠腔里，才能对肠壁牵张感受器产生足够强的刺激继而产生便意。由于抑制便意，粪便在直肠内停留时间延长，水分过度吸收，造成粪便干结，且体积变小，对肠壁的刺激减弱，进一步加重便秘，形成恶性循环。克制排便可能会使调节肠道活动的神经反射协调性被打乱，使得正常的直肠刺激难以产生便意。主动克制排便时需要收紧盆底肌和肛门括约肌，长时间持续这一动作可能会导致盆底肌功能障碍。在排便时这些肌肉无法有效放松，甚至反而会紧张性收紧，导致排便困难，反复加重便秘。
3.2.4　吸氧不足
吸氧不足导致的机体慢性缺氧会引起交感神经兴奋，胃肠道血管收缩血供减少，使胃肠蠕动功能和吸收功能降低，从而引起便秘。另外吸氧不足与便秘的关系可能与脱水相关。因吸氧不足机体缺氧会引起呼吸加深加快，通气量增加，经呼吸道丢失水分明显增多。机体在缺氧适应阶段，会出现轻度利尿现象，导致水分经尿液排出增多。以上原因会导致肠道过度吸收水分，加重便秘。
3.2.5　缺乏运动
部队进入高原后体能训练强度明显下降。当缺乏运动时，肠道蠕动会变得迟缓、无力，这导致食物残渣在结肠中停留时间过长，其中水分被过度吸收，最终使大便变得干硬、难以排出。缺乏锻炼会导致腹肌和盆底肌群力量减弱，功能协同失调以及排便时直肠动力不足。另外缺乏运动可能影响胃肠道激素的分泌和神经调节，间接干扰肠道功能。
3.3　高原FC防治措施建议
3.3.1　改善住宿条件，优化管理制度
近年来高原驻训部队建设水平及保障能力明显提高，但厕所建设相对滞后，目前仍以室外旱厕为主，且人均如厕单元相对不足。增加厕所数量，实现厕所室内化和保温化，适当调整作息时间管理，增加官兵早晨自由支配时间等措施可明显缓解官兵如厕前心理焦虑，减少克制排便的发生。同时要教育引导官兵主动养成较为规律的排便习惯，训练自身有效的排便反射功能，减少便秘的发生。
3.3.2　调整饮食习惯，适度体能活动
高原驻训部队制定营养配餐计划时，要结合自身任务特点及高寒缺氧环境。高原环境基础代谢率增加，能量消耗大，建议增加热量摄入，保持平衡膳食，增加优质蛋白供应。为增加膳食纤维摄入，主食可用全谷物及杂豆类替代部分精米白面。保障足量的蔬菜摄入，尤其在冬季要保证绿叶蔬菜的供应。注意采用蒸煮、快炒、凉拌等方式，避免过度烹饪破坏膳食纤维。适当摄入健康油脂，避免全素饮食。减少油炸类及精加工面点类零食，把水果或坚果类作为日常零食。适量增加酸奶、泡菜、豆豉等发酵食品可补充益生菌，改善肠道菌群平衡。野外训练时午餐尽量供应热食，并保障热水供应，建议每日饮水量2 000 mL左右。平时体能训练以低、中强度有氧运动为主。便秘症状者可有针对性地加强腹肌、膈肌等核心肌群训练，以及坚持做提肛锻炼训练盆底肌群，进而增强排便的协调性运动，减轻便秘症状。
3.3.3　加强心理疏导，调整心理状态
加强部队心理服务工作，开展心理筛查，建立心理健康档案，建设心理骨干队伍等措施，提高部队心理服务能力。官兵可以通过这些心理疏导和相应的训练，提高心理素质，缓解不良情绪，从而降低心理因素引起的便秘的发生率。同时加强宣传教育，使官兵认识到心理因素与FC的关系，认识到便秘的危害，努力改变不良的生活习惯，学会自我维护心理及生理健康。
3.3.4　合理药物治疗
部分患者对于以上一般治疗效果不明显，且便秘症状较重，可考虑给予药物治疗。常用药物有各类导泻剂、促进胃肠蠕动药物和微生态制剂。其中微生态制剂可改善腹胀等症状，调节肠道菌群的平衡，治疗过程中不良反应较轻。与传统治疗方法相比，微生态制剂治疗慢性便秘具有一定优势，值得在高原部队进一步推广［14］。同时药物治疗应建立在一般治疗的基础上，遵循用药个体化等基本原则，避免长期服用导泻剂导致的结肠黏膜损伤，以及产生药物依赖。
综上所述，高原官兵FC患病率较高，值得重视，多种危险因素与患病率相关。制定科学合理的防治措施，降低FC患病率，对维护部队安全稳定，保障官兵的身心健康，提高战斗力有重要意义。

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2026年第48卷第1期
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doi: 10.16016/j.2097-0927.202511057
  • 接收时间：2025-10-25
  • 首发时间：2026-10-23
  • 出版时间：2026-01-15
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  • 收稿日期：2025-10-25
  • 修回日期：2025-11-30
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    1中国人民解放军陆军第九四六医院普通外科，新疆伊宁

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窦维龙，E-mail：
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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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