招飞体检、飞行人员年度体检和住院鼻科疾病谱比较

Comparison of physical examination in recruitment of aircrews and annual physical examination of aircrews with rhinogical disease spectra of hospitalized aircrews

目的对招收飞行学员体检鼻科淘汰病症谱、飞行人员年度体检和住院鼻科疾病谱(简称为招飞体检、年度体检及住院鼻科疾病谱)进行比较,为航卫保障提供参考。方法收集某战区2006年-2011年招飞体检鼻科淘汰资料407份,某疗养机构2005年-2011年飞行人员年度体检鼻科疾病资料1 072份及某医院1966年-2011年飞行人员因鼻科疾病住院的病例资料306份355例次。统计出招飞体检、年度体检及住院鼻科疾病谱,并进行对比分析。结果 1)排在招飞体检鼻科疾病谱前5位的为鼻中隔偏曲(35.38%),鼻道窦口复合体异常(31.94%),慢性鼻-鼻窦炎(14.99%),变应性鼻炎(11.79%),慢性鼻炎(2.46%);排在年度体检鼻科疾病谱前5位的为慢性鼻炎(26.68%),鼻中隔偏曲(17.16%),慢性鼻-鼻窦炎(11.57%),鼻窦囊肿(10.45%),鼻窦气压伤(9.79%);排在住院鼻科疾病谱前5位的为慢性鼻-鼻窦炎(22.54%),鼻窦气压伤(20.85%),鼻中隔偏曲(15.21%),变应性鼻炎(14.65%),鼻窦囊肿(8.73%)。2)鼻中隔偏曲在招飞体检疾病谱中的构成比显著高于在年度体检和住院疾病谱中的构成比(χ2=56.72 vsχ2=40.11,P<0.01);鼻道窦口复合体异常在招飞体检疾病谱中的构成比显著高于鼻窦气压伤在年度体检和住院疾病谱中的构成比(χ2=108.26 vsχ2=11.91,P<0.01),鼻窦气压伤在年度体检疾病谱中的构成比较住院疾病谱高(χ2=29.68,P<0.01);变应性鼻炎在年度体检疾病谱中的构成比较住院中高(χ2=7.00,P<0.01)。结论招飞鼻科体检应重点关注鼻中隔偏曲、鼻道窦口复合体异常、慢性鼻-鼻窦炎和变应性鼻炎;飞行人员年度体检应注意把握送院指征,特别关注鼻科疾病与气压伤的关系。

Objective To provide reference for aviation medical support by comparing the physical examination in recruitment of aircrews and annual physical examination of aircrews with rhinogical disease spectra of hospitalized aircrews. Methods Eliminated nasal examination medical record data about 407 candidates for recruitment of pilots in 2006-2011, annual nasal examination medical record data about 1 072 aircrews in 2005 to 2011 and medical record data about 306 aircrews （355 cases/time） admitted to hospital due to nasal disease were compared with their disease spectra. Results The top 5 disease spectra observed in nasal examination for recruitment of pilots were deviation of nasal septum（35.38%）, abnormalities of ostiomeatal complex（31.94%）, chronic rhinosinusitis（14.99%）, allergic rhinitis （11.79%） and chronic rhinitis（2.46%）. The top 5 diseases spectra in annual physical examination of aircrews were chronic rhinitis （26.68%）, deviation of nasal septum （17.16%）, chronic rhinosinusitis（11.57%）, cyst in nasal sinus（10.45%） and sinus barosinusitis（9.79%）. The top 5 disease spectra of hospitalized aircrews were chronic rhinosinusitis（22.54%）, sinus barosinusitis（20.85%）, deviation of nasal septum （15.21%）, allergic rhinitis（14.65%） and cyst in nasal sinus（8.73%）. The proportions of deviation of nasal septum, sinus barotrauma and allergic rhinitis were significantly higher in nasal examination for recruitment of pilots and annual physical examination of pilots than in hospitalized aircrews （ χ2=56.72 and 40.11, χ2=108.26 and 11.91, χ2=108.26 and 11.91 vsχ2=29.68, P〈0.01）. Conclusion Attention should be paid to deviation of nasal septum, abnormalities of ostiomeatal complex, chronic rhinosinusitis, allergic rhinitis in nasal examination for recruitment of pilots, and the indications for sending pilots to hospital, especially the relation between nasal diseases and barotraumas, in their annual physical examination.