飞行员甲状腺功能亢进症的治疗效果与医学鉴定

Curative effect and medical assessment of hyperthyroidism in pilots

目的 总结飞行员甲状腺功能亢进症 (甲亢 )治疗和医学鉴定的经验 ,为不断完善飞行员体格检查标准提供参考。 方法 回顾性分析 1983年 1月～ 2 0 0 3年 1月间 13例飞行员甲亢的临床治疗效果及其飞行鉴定结论。 结果 ①口服抗甲状腺药物治疗 12例 ,其中 9例甲状腺功能恢复正常 ,恢复飞行 ,3例于 2年后复发而手术治疗 ;②手术治疗 3例 ,均出现甲状腺功能减退 ,2例经甲状腺激素替代治疗后飞行合格 ;③ 1例恶性突眼病例用同位素治疗后停飞。 结论 ①飞行员甲亢患者 ,以口服抗甲状腺药物治疗作为首选 ,达到临床治愈标准 ,可恢复飞行 ;②甲亢手术治疗愈后合并甲减的运输机或轰炸机飞行员 ,经甲状腺激素替代治疗而使甲状腺功能正常者 ,也可恢复飞行。

Objective To sum up the experience of treatmentand assessment of hyperthyroidism in pilots, so as to provide reference for the perfection of medical standards for selection and retentionof flying personnel. Methods The medical history and medical assessment of 13 pilot cases of hyperthyroidism hospitalized in Naval General Hospital from 1983 to 2003 were reviewed. Results ①Most cases (12/13) were treated firstly by antithyroid drugs, euthyroid status was produced in 9 cases and returned to flying duty. ②Hyperthyroidism recurred 2 years after antithyroid drug treatmentin three cases, and were treated surgically. All of them resulted in hypothyroidism, and two of them returned to flying duty after a euthyroid condition was attained following thyroxine replacementtreatment. ③A malignant exophthalmus case was directly treated iodine radioisotope, euthyroidcondition did not produce and grounded after follow-up for 2 years. Conclusions ①For treatment of pilot cases of hyperthyroidism, oral administration of antithyroid drug is the first choice. In case of euthyroid condition was attained, a return to flying duty should be considered. ②When hypothyroidismwas resulted from surgical treatment of hyperthyroidism, a return to flying duty can be considered after successful replacement thyroxine treatment in bomber and transport pilots.