飞行人员肝炎病毒感染66例的临床特点及医学鉴定

Clinical characteristics and medical evaluation of 66 pilots hepatitis virus infection

目的通过了解飞行人员肝炎病毒感染的临床特点以及对飞行的影响,为飞行人员的病毒性肝炎防治及医学鉴定提供对策和依据。方法回顾性分析我院1993年1月-2012年12月间住院诊治的飞行人员肝炎病毒感染患者的临床病历资料。结果 20年间飞行人员肝炎病毒感染发病人数逐年减少,住院患者66例,占同期飞行人员住院患者的0.58%,近5年来下降至0.26%,与前15年间0.83%比较明显下降(P<0.001);在同期传染病中占比为61.11%,近5年为72.22%,与前15年间58.89%比较仍为传染病中最主要种类(P>0.005);临床感染类型包括甲型肝炎病毒感染3例(4.62%)、乙型56例(84.85%)、丙型4例(6.15%)和戊型3例(4.62%),乙型肝炎病毒感染最多。临床表现绝大多数症状轻微,较多的是乏力(34.85%)、纳差(18.18%)和肝功能异常,其中ALT升高26例(39.39%),AST升高22例(33.33%)。66例患者中,飞行结论不合格52例,停飞率78.79%。51例为乙型肝炎病毒感染,1例为丙型肝炎病毒感染。结论飞行人员肝炎病毒感染的发病率和在飞行人员疾病构成上的比例总体上在逐年下降,但仍是传染病的最主要部分,主要以乙型肝炎病毒感染为主,肝炎病毒感染是飞行人员传染病中最常见的疾病,也是停飞的最主要的原因。

Objective It was to investigate the pilot hepatitis viral infection and its clinic characteristics and the impacts on flying.We intended to provide evidence for and solution to pilot viral hepatitis prevention and treatment and medical evaluation.Methods The clinical data of 66 pilots who suffered from viral hepatitis and was hospitalized in our hospital from January 1993 to December 2012 was analyzed.Results During the past 20 years,66 pilots suffering from viral hepatitis accounted for 0.58% of total pilot patients in hospital.As for the recent 5 years,the ratio declined to 0.26% and was significantly lower than that of 0.83% 15 years previously（P0.001）.In the same period the ratio was 61.11% of infectious disease,and in the recent 5 years was 72.22%.Still it was the main type of infectious diseases during the past 15 years with 58.89%（P0.005）.Clinical types of infections included hepatitis A virus infection with 3 cases（4.62%）,56 cases of hepatitis B（84.85%）,4 cases of hepatitis C（6.15%） and 3 cases of hepatitis E（4.62%）,the most of which was hepatitis B virus infection.The clinical manifestations of the vast majority showed mild symptoms,and many cases felt weak（34.85%）,or had no appetite（18.18%） or abnormal liver function.ALT increased in 26 patients with 39.39%;AST increased in 22 cases with 33.33%.Among the 66 pilots who were infected with hepatitits virus,52 were evaluated unqualified for flying.The rate of suspension of flying was 78.79%.51 cases suffered from hepatitis B virus infection,1 cases of hepatitis C virus infection.Conclusions The number and ratio of pilots suffering from hepatitis viral infection among in-hospital pilots were declining year by year,but majority of them were sick with infectious disease.The spectrum of infectious diseases concentrated on virul hepatitits B.Viral hepatitis was the most common infectious disease in pilot disease,which was the major cause to suspension of flying.