飞行人员精神类疾病诊治特点及航空医学鉴定

Diagnosis and treatment of psychotic disorders in aircrews and aeromedical assessment

目的 总结患精神类疾病飞行人员的临床资料,为相关疾病的诊治及医学鉴定提供参考. 方法 回顾分析126例飞行人员精神类疾病的临床资料并复习相关文献,按中国精神障碍诊断分类及诊断标准第三版对病例资料进行疾病分类.依据空军飞行人员体格检查标准（1996年）,并参考美国相关标准,进行医学鉴定. 结果 126例飞行人员精神类疾病中,癔症、应激相关障碍、神经症63例;情感性精神障碍54例;心理因素相关生理障碍之失眠症9例.医学鉴定结论：18例飞行合格,29例暂时飞行不合格,79例飞行不合格. 结论 飞行人员精神类疾病种类较多,诊治有其特殊性;应根据空军飞行人员体格检查标准,借鉴美国相关标准,结合飞行机种、职别、飞行经验、个人意向及部队需求进行医学鉴定.

Objective To provide reference for the diagnosis,treatment and medical assessment of psychotic disorders in aircrews by summarizing the clinical data of psychotic disorders in aircrews.Methods Retrospective analysis of the clinical data of 126 cases of the aircrews with psychotic disorders and relevant literature review were done.The disorders were classified by the third edition Chinese Classification and Diagnostic Criteria of Mental Disorders.The medical identification was made in accordance with the Physical Examination Standards of Air Force Flight Personnel （1996）,and referred to the relevant standards of the United States.Results In 126 aircrew cases with psychotic disorders,there were 63 cases with hysteria,stress-related disorders,and neurosis.There were 54 cases with mood disorders.There were 9 cases with the insomnia due to physiological disorders related psychological factors.The conclusion of medical assessment：18 cases were qualified,29 cases were temporary grounding,and 79 cases were disqualified.Conclusions There are many kinds of psychotic disorders in aircrews.Diagnosis and treatment have certain particularities.The medical identification should be in accordance with the physical examination standard of Air Force flight personnel and take the waiver standards of foreign flight personnel identification as reference.Moreover,the type of aircraft,post of flight,flight experience and personal intention,as well as the needs of army are suggested to be the concerns in medical identification.