1993-2012年住院飞行人员传染病疾病谱及医学鉴定

Aircrew infectious disease spectrum from 1993 to 2012 and medical evaluation

目的 通过了解住院飞行人员传染病疾病谱和临床特点以及对飞行的影响,为飞行人员的传染病防治及医学鉴定提供依据. 方法 回顾性分析空军总医院1993年5月-2012年8月住院诊治的飞行人员传染病患者的临床病历资料. 结果 19年间传染病住院飞行人员共105例,占同期飞行人员住院人数的0.93％；近5年来下降至0.31％(15/4915),与其他时期比,差异有统计学意义(P＜0.05).飞行人员传染病发病人数呈逐年减少趋势(x2=53.354,P＜0.01).105例传染病疾病分类共12种,排在前3位的是病毒性肝炎(65例)、细菌性痢疾(11例)和感染性腹泻(8例).肝炎病毒感染最为常见,占本组传染病疾病构成比的61.90％；其中乙型肝炎病毒感染51例,占本组传染病疾病构成比的48.57％.105例中医学鉴定结论为飞行不合格52例,停飞率49.52％.65例肝炎病毒感染者中飞行不合格52例,停飞率80.00％;3例地面观察期,待做医学鉴定.其他40例患者中除2例尚在康复治疗外,均经临床治疗后康复痊愈,医学鉴定结论为飞行合格. 结论 飞行人员传染病的发病率及其在飞行人员疾病构成上的比例总体上呈逐年下降,疾病谱相对单一,主要以病毒性肝炎特别是乙型病毒性肝炎和肠道感染性疾病为主,乙型病毒性肝炎是飞行人员传染病中最常见的疾病,也是停飞的最主要原因.

Objective To provide prevention,treatment and medical evaluation references by investigating the aircrew infectious disease spectrum and clinic characteristics,as well as the impacts on flying.Methods The clinical data of the aircrews,who suffered from infectious diseases and hospitalized in Air Force General Hospital from May 1993 to August 2012,were analyzed retrospectively.Results One hundred and five infectious disease aircrews accounted for 0.93％ of total hospitalized aircrews in that period.In recent 5 years,the ratio declined to 0.31％ (15/4915) and was significantly lower than that of other periods (P＜ 0.05).The infection disease incidence showed decrease trend by year (x2 =53.354,P＜0.01).The 105 cases covered 12 infectious diseases.The top 3 infectious diseases in the spectrum were viral hepatitis (65/105),bacillary dysentery (11/105) and infectious diarrhea (8/105).Viral hepatitis was invasive most and took 61.90％ of total infectious diseases,including hepatitis B virus infection that accounted for 48.57％ of total infectious diseases (51/105).Out of 105 aircrews 52 were disqualified for flying and the grounding rate was 49.52％.Among 65 hepatitis virus infected aircrews,52 (80.00％) were grounded while 3 aircrews were under supervision and stood for final medical evaluation.The rest 40 aircrews were recovered bv medical treatment and were qualified for flying excepted 2 aircrews who were recovering under rehabilitation treatment.Conclusion The number and ratio of the hospitalized aircrews with infectious diseases are declined year by year.The viral hepatitis and intestinal infectious diseases take the top 2 in the spectrum of infectious disease.Especially the viral hepatitis B is the most prevalent infectious disease and becomes a major cause of aircrew's grounding.