飞行员丙型肝炎病毒感染的临床诊治及航空医学鉴定

Clinical diagnosis and treatment and aviation medical evaluation of pilots hepatitis C virus infection

目的 通过5例飞行员丙型肝炎病毒感染的诊治过程,探讨飞行员丙型病毒性肝炎诊治及医学鉴定原则。方法 回顾性分析我院5例飞行员丙型肝炎病毒感染的诊治、随访过程及最终医学鉴定结果,并进行文献复习。结果 5例患者均系住院或改装体检时发现抗-HCV阳性,均无明显临床症状。肝功能轻度异常,HCV-RNA定量分析阳性;1例为基因1b型。3例患者发病前有手术外伤史,1例有牙科治疗史;4例患者接受聚乙二醇干扰素0-2a及利巴韦林抗病毒治疗,病毒阴转临床治愈,地面观察3-11个月后给予飞行合格,随访1-3年无复发,1例未接受抗病毒治疗,飞行不合格。结论 飞行员丙型肝炎病毒感染途径不清,可能与外伤手术及牙科治疗有关,发病隐匿,症状轻微。及时给予抗病毒治疗可以清除病毒临床治愈,飞行合格。

Objective To investigate the clinic diagnosis, treatment and aviation medical evaluation of hepatitis C viral infection among the pilots with reference to the diagnosis and treatment of hepatitis C virus infection in 5 cases Methods The diagnosis, treatment, follow-up and final results of medical evaluation of 5 cases of hepatitis C virus infection in our hospital were retrospectively analyzed in addition to literature review. Results Five patients were found to be anti-HCV positive during hospitalization or modified physical examination without any obvious clinical symptoms, who had mildly abnormal liver function and tested positive by quantitative analysis of HCV-RNA. One case was of gene lb type. Three cases were treated with with polyethylene glycol interferon surgical trauma and one case had a history of dental treatment. Four cases were treated and ribavirin antiviral therapy until the virus became negative and the qualification of flight was issued after 3 to 11 months up. One case did not receive the anti of ground observation, and no recurrence was found during the 1 to 3 years of follow- viral treatment so that the qualification of flight was not released. Conclusion How pilots become infected with hepatitis C virus is not clear, possibly related to trauma surgery and dental treatment. The onset is occult with mild symptoms. Timely antiviral treatment can effectively remove the virus.