军事飞行人员肺大疱患病情况调查及相关因素分析

Investigation on pulmonary bullae disease in military flight crew and analysis of related factors

目的探讨军事飞行人员肺大疱的发生率及相关因素,为气胸的预防和鉴定提高参考。方法回顾性分析2020年7~12月在疗养中心疗养的1636例军事飞行人员的胸部CT检查结果,分析肺大疱检出情况及发生部位,比较不同年龄、机种、飞行时间肺大疱检出率以及吸烟、体重指数(BMI)对肺大疱的影响,以明确发生肺大疱的危险因素。结果1636例受检飞行人员中,共检出肺大疱64例,总检出率为3.91%,发生部位以肺上叶(42.2%)和双肺(40.6%)居多;随着年龄、飞行时间的增长,肺大疱检出率有增高趋势(P<0.01);不同机种飞行人员肺大疱检出率不同,其中以运输机歼击机多发,差异有统计学意义(P<0.05);吸烟者肺大疱检出率高于非吸烟者,差异有统计学意义(P<0.05),肺大疱检出者与未检出者BMI值未见统计学差异(P>0.05)。结论军事飞行人员虽然经过严格的招飞筛选,但仍存在一定比例的肺大疱,且与年龄、机种、飞行时间、吸烟等因素有关。应重视飞行人员肺大疱的筛查与鉴定,并做好针对性预防工作,最大限度地消除飞行安全隐患。

Objective To investigate the incidence and related factors of pulmonary bullae in military flight crew, thus providing a reference for the prevention and identification of pneumothorax. Methods The chest CT findings of 1636 military flight crews who recuperated in our center from July to December 2020 were analyzed retrospectively. The detection and site of pulmonary bullae were analyzed. The detection rate of pulmonary bullae in different ages, types of aircraft and flight time, as well as the influence of smoking and BMI on pulmonary bullae were compared, to clarify the risk factors of pulmonary bullae. Results In total, 64 out of 1636 subjects were diagnosed with pulmonary bullae, with a total detection rate of 3.91%. Lesions were typically located at upper lobe of lung(42.2%) and bilateral lungs(40.6%). The older the subject and the longer the flight time, the detection rate of bullae tends to rise(P < 0.01). The detection rate varies among different types of airplane, especially higher in transport aircrafts and fighter aircrafts, and the difference was statistically significant(P < 0.05). The detection rate of bullae in smokers was higher than that in non-smokers, and the difference was statistically significant(P < 0.05). There was no statistically significant difference in BMI between bullae group and non-bullae group(P > 0.05). Conclusion Although military pilots are subject to strict screening during recruitment, there is still a certain proportion of pulmonary bullae, which is related to age, type of airplane, smoking and flying time. Screening and identification of pulmonary bullae in flight personnel shall be taken seriously, coupled with proper targeted prevention, with a view to minimizing the hidden risks during flight.