空军飞行人员肾癌6例诊治及航空医学鉴定

Diagnosis and treatment of renal carcinoma in pilots: A report of 6 cases

目的分析飞行人员肾癌的诊治及飞行结论鉴定。方法 2008年1月-2012年11月我院治疗因肾癌住院的飞行人员6例。回顾性分析患者的病史、诊断、治疗经过及飞行结论等资料。结果 6例中4例系年度体检偶然发现,1例因查尿发现镜下血尿,1例因间断性右腰腹部疼痛伴肉眼血尿进一步检查发现。6例均为单侧发病,单个肿瘤,左侧4例,右侧2例。肿瘤平均最大径为(3.2±1.6)cm。6例均接受了手术治疗,其中2例采用常规手术方式,4例采用后腹腔镜微创手术;部分切除和根治性切除各3例。术后病理均为透明细胞癌。2例手术后时间不足3个月仍在地面观察,3例恢复飞行,1例停飞。结论飞行人员肾癌多为体检发现,多无症状;治疗及时且效果好,可以恢复飞行。

Objective To analyze the diagnosis and treatment of renal carcinoma in pilots. Methods Clinical data about 6 renal carcinoma pilots （including their medical history, diagnosis, treatment and flying conclusion） admitted to our hospital from January 2008 to December 2012 were retrospectively analyzed. Results Among the 6 pilots, renal carcinoma was detected in 4 in their annual physical examination, in 1 due to microscopic hematuria in urine test, and in 1 due to intermittent fight waist pain accompanying gross hematufia. Only one kidney was involved in the 6 pilots and only one renal carcinoma was detected in each pilot. Carcinoma was detected in the left kidney of 4 pilots and in the fight kidney of 2 pilots. The maximal average diameter of renal carcinoma was 3.2 ± 1.6 cm. Of the 6 pilots, 2 received traditional surgical treatment and 4 underwent laparoscopic operation. The carcinoma was partially removed in 3 pilots and completely removed in 3 pilots. The pilots were diagnosed with hyaline cell cancer. Two pilots were observed on ground within 3 months after operation and 3 resumed flying. Conclusion Renal carcinoma is usually detected in pilots in physical examination without symptoms. Its prognosis is good if treated in time. Most renal carcinoma pilots can resume their flying after treatment.