飞行人员自发性气胸的航空医学鉴定

Medical assessment of spontaneous pneumothorax in aircrew

目的总结1例飞行员自发性气胸的诊治及鉴定过程,提出飞行人员自发性气胸的鉴定建议。方法回顾我科收治的1例自发性气胸飞行员的诊治、鉴定过程,并总结我院近5年体检发现的5例肺大疱飞行人员资料,提出自发性气胸飞行人员的航空医学鉴定建议。结果男性飞行员,39岁,因劳累后感右侧胸部隐痛入院。胸片示右侧液气胸,右肺压缩70%。给予胸腔闭式引流、吸氧等治疗。6个月后复查肺完全复张,肺功能恢复正常。医学鉴定结论为双座飞行合格。其他5例体检发现肺上有肺大疱的飞行人员均未发生气胸。结论自发性气胸在飞行结论鉴定时应综合发作次数、肺大疱位置、飞行机种及飞行人员个人意愿等情况而定。

Objective To put forward the suggestions for medical assessment of spontaneous pneumothorax in aircrew by summarizing its diagnosis, treatment and medical assessment in a pilot. Methods The diagnosis, treatment and medical assessment of spontaneous pneumothorax in a pilot admitted to our hospital were retrospectively analyzed. Suggestions were put forward for the medical assessment of spontaneous pneumothorax in aircrew by summarizing the clinical data about 5 aircrew with blebs found in physical examination in the past 5 years. Results The patient was a male pilot aged 39 years. He was admitted to our hospital because of mild chest pain. X-ray showed hydropneumothorax in his right chest with 70% of the right lung compressed. Six months after he was treated with closed thoracic drainage and oxygen inhalation his lungs were fully expanded with their function recovered. Medical assessment concluded that he was qualified for flying a double-seats aircraft. No pneumothorax was detected in physical examination of the other 5 aircrew with blebs. Conclusion Whether aircrew with spontaneous pneumothorax are qualified to fly should be assessed depending on the attacks of pneumothorax, sites of blebs, types of aircraft, and desire of aircrew to fly.