歼击机飞行员体能训练致横纹肌溶解症一例并文献复习

One case of fighter pilot with exercise-induced rhabdomyolysis and literature review

目的 探讨飞行员运动性横纹肌溶解症的诊断、治疗及医学鉴定,以提高对本病的认识,指导临床航空医疗工作和飞行员体能训练. 方法 分析1例飞行员运动性横纹肌溶解症的诊断、治疗、医学鉴定情况,结合相关文献,总结飞行员运动性横纹肌溶解症的病因、发病机制、临床特点、防治及医学鉴定. 结果 突然大量运动训练可导致机体能量耗损,自由基产生增加,组织渗透性加强,从而引起炎性因子释放,造成横纹肌溶解.本例飞行员经针对病因治疗,减少横纹肌损伤,恢复血流,防治急性肾功能衰竭等治疗,临床治愈.经康复疗养、地面观察,逐渐恢复体能训练,复查各项指标均正常,结论为飞行合格. 结论 运动性横纹肌溶解症是由于过度运动后所致的横纹肌损伤,对该病要做到预防为主,早发现、早诊断、早治疗,对飞行员改善预后和医学鉴定有着重要的临床意义.

Objective To improve the understanding of exercise-induced rhabdomyolysis by reviewing the diagnosis,treatment and medical evaluation of the disease and to guide aeromedical work and training technology.Methods One case of pilot with exercise-induced rhabdomyolysis was reviewed on clinical data,treatment,and medical evaluation.Combining with the relevant literatures,the etiology,pathogenesis,clinical features,prevention and medical evaluation were discussed.Results Sudden applied high strength exercise resulted in the energy depletion of body,increased the product of free radicals and pressurized the tissue permeability,then caused the release of inflammatory cytokines,and finally,the rhabdomyolysis.Aiming at the cause of the disease,such treatments as reducing skeletal muscle damage,restoring blood flow,preventing and treating acute renal failure,etc.were done and the pilot was eventually cured.He was qualified with normal state on the base of convalesce therapy,follow-up,and gradually restored physical training.Conclusions Exercise-induced rhabdomyolysis is due to the striated muscle damage in excess exercises.Prevention first is suggested and the early detection,diagnosis and treatment would be benefit to prognosis and valuable to medical evaluation.