飞行人员喉科疾病的诊治及医学鉴定

Diagnosis,treatment and medical evaluation of laryngeal diseases in aircrew

目的总结飞行人员喉科疾病的临床诊治和医学鉴定经验。方法分析我院1967年3月-2013年2月期间飞行人员喉科疾病病历资料,并与本课题组既往报道的飞行人员鼻科资料相关疾病构成比进行比较。结果①46年间62人64例飞行人员喉科疾病分布为:声带息肉29例,会厌囊肿13例,慢性喉炎8例,慢性咽喉炎3例,急性喉炎和急性会厌炎各2例,急性咽喉炎、亚急性喉炎、会厌溃疡、会厌乳头状瘤、声带乳头状瘤、声带麻痹、声带囊肿各1例;②本组喉科资料会厌囊肿的构成比20.31%(13/64)、声带息肉的构成比45.31%(29/64)分别与课题组既往报道的鼻科资料中鼻窦囊肿的构成比8.85%(33/373)、鼻息肉的构成比21.98%(82/373)相比较,分别为7.62和15.69,均P<0.01;③62人经保守或手术治疗后均恢复飞行。结论飞行人员喉科疾病呈下降趋势,其治疗效果好,复飞率高,航空环境气压变化的反复刺激可能是飞行人员喉科疾病的重要发生机制之一。

Objective The method was to sum up the experiences of diagnosis,treatment and medical evaluation of laryngeal diseases in aircrew.Methods We analyzed the laryngeal diseases record data of aircrew patients in our hospital during the period from March 1967 to February 2013,and compared the data with the constituent ratio of relative rhinology diseases from our previous study.Results ①Among the 64 cases of 62 aircrew of laryngeal diseases during the past 46 years,there were 29 cases of vocal cords polyps,13 cases of epiglottic cysts and 8 cases of chronic laryngitis,3 cases of chronic pharyngolaryngitis,②cases of acute laryngitis and acute epiglottitis respectively,and 1 case of acute pharyngitis,sub-acute laryngitis,epiglottic ulcers,epiglottic papilloma,vocal cords papilloma,vocal cord paralysis,vocal cord cyst respectively.③We compared the constituent ratio of epiglottis cysts with 20.31%（13/64）and vocal cords polyps with 45.31%（29/64） to the constituent ratio of cyst of nasal sinus with 8.85%（33/373）and polyp of nasal sinus with 21.98%（82/373）respectively,the were 7.62 and 15.69 respectively,and P0.01;3.All the 64 case of aircrews have continued their flying jobs through conservative treatment or surgical treatment.Conclusions There was a downward trend of laryngeal diseases with aircrew in recent years,and the treatment of laryngeal diseases was effective and the rate of return to flight duty was high.Barotrauma due to repeated rising and falling during flying might be one of the important mechanism underlying laryngeal diseases in aircrew.