民航招飞体检中肛门疾病的体格检查与航空医学鉴定

Physical examination and aviation medical assessment of anal diseases for civil aviation recruit

目的:探讨招飞体检中肛门疾病的体格检查方法与体检鉴定原则,以期提高检查诊断水平和鉴定水平。方法:回顾分析南航航空医学鉴定中心2013年度招飞体检中有关肛门疾病的病例及肛门的检查方法,医学标准是"《民用航空招收飞行学生体格检查鉴定规范》(MH/T 7013-2006)"。结果:参加南航2013年度首次招飞体检的受检者共7038人,其中外科肛门疾病不合格人数共52人,占总不合格人数4.7%。不合格的肛门疾病为:血栓性外痔9例;多发内痔及混合痔17例;直肠粘膜脱垂5例;肛瘘11例;严重的肛周皮肤湿疹4例;肛周皮肤色素脱失、肛门白斑3例;慢性肛裂(伴前哨痔)3例。另发现肛门疾病且鉴定为合格的共63人。结论:由于肛门所在的解剖位置特殊,易出现漏诊及误诊,掌握正规的检查方法和流程,准确把握招飞医学鉴定标准,有助于提高诊断水平,减少漏诊及误诊。

Objective： To explore the examination methods and identification of anal diseases for civil aviation recruit in order to improve the examination、diagnosis and identification.Methods： The cases of civil aviation recruits＇ anal diseases examination in 2013 were reviewed and the commonly used examination methods were analyzed.The corresponding standards referred to＂Appraisal standard of physical examination for recruitment of civil aviation airman trainees（MH / T 7013-2006） ＂.Results： 52 of 7038 recruits（4.7%） were disqualified in surgery examination because of anal diseases,included 9 cases of thrombotic external hemorrhoids,17 cases of multifocal internal hemorrhoids and mixed hemorrhoids,5 cases of rectal prolapse,11 cases of anal fistula,4 cases of serious eczema,3 cases of leukoplakia and 3 cases of anal fissure.63 recruits with anal diseases were assessed as fit.Conclusions： Misdiagnosis of anal diseases is easily happened because of anatomical position reason.It is suggest that to improve assessment and reduce misdiagnosis rate by mastering proper examination as well as grasping the appraisal standard of physical examination for recruitment of civil aviation airman trainees.