飞行人员鼻窦炎鼻息肉的临床诊治和医学鉴定研究

Diagnosis,treatment and medical evaluation of sinusitis and nasal polyp in aircrew

目的:总结飞行人员鼻窦炎鼻息肉的临床诊治和医学鉴定经验。方法:分析飞行人员鼻窦炎鼻息肉资料93份。结果:急性鼻窦炎11例,慢性鼻窦炎鼻息肉82例。慢性鼻窦炎鼻息肉Ⅰ类46例(包括Ⅰa地面有症状39例和Ⅰb体检时发现7例),Ⅱ类36例(地面无症状、飞行中有继发性气压伤,包括Ⅱa继发性鼻窦气压伤14例,Ⅱb继发性耳气压伤13例,Ⅱc继发性鼻窦气压伤+耳气压伤9例)。慢性鼻窦炎鼻息肉Ⅰ型1期24例,Ⅰ型2期38例,Ⅰ型3期7例;Ⅱ型1期2例,Ⅱ型2期6例,Ⅱ型3期3例;Ⅲ型2例。84例恢复飞行,9例永久停飞。结论:鼻窦炎鼻息肉可直接或因继发性气压伤而危及飞行安全,慢性鼻窦炎鼻息肉伴继发性耳气压伤者是医学停飞的重要原因,患鼻窦炎鼻息肉的飞行人员只有在获得良好治疗效果及耳气压功能和鼻窦气压功能正常的情况下方可恢复飞行。

Objective： To sum up the experiences of diagnosis, treatment and medical evaluation of sinusitis and nasal polyp in aircrew. Method： Ninety three aircrew with sinusitis and nasal polyp were included in the study. Result：There were 11 cases with acute sinusitis and 82 cases with chronic sinusitis and nasal polyp. Of the 82 ca ses, there were 46 cases in class Ⅰ （including 39 cases with symptoms and signs on ground in Ⅰa, 7 cases only with signs in Ⅰb ）, 36 cases in class Ⅱ （no symptoms on ground but with symptoms of secondary barotraumas in flight, including 14 cases withsecondary barosinusitis in Ⅱa, 13 cases with secondary barotrauma in Ⅱb, 9 cases with sec ondary barosinusitis and barotrauma inⅡc）. Of the 82 cases,there were 24 cases in 1 stage of type Ⅰ , 38 cases in 2 stage of typeⅠ , 7 cases in 3 stage of type Ⅰ , 2 cases inl stage of type Ⅱ, 6 cases in2 stage of type H, 3 cases in 3 stage of type Ⅱ , 2 cases in type Ⅲ. Eighty four cases continued their flying jobs and 9 cases were permanently grounded. Conclusion： Flying safe can be endangered by sinusitis and nasal polyp alone or with its secondary barotraumas. Chronic sinusitis and nasal polyp complicated with barotraumas are important causation for medical grounding. The airerew with sinusitis and nasal polyp will be allowed to continue their flying jobs only after getring well curative effect and normal gas pressures of ear and nasal sinus.