女飞行员盆底功能障碍性疾病2例并文献复习

Pelvic floor dysfunction in 2 female pilots and literature review

目的探讨女飞行员盆底功能障碍性疾病发病及相关情况。方法回顾分析2例女飞行员盆底功能障碍性疾病的临床诊治及航空医学鉴定情况,应用盆底超声结合临床进行诊断,并进行国内外文献复习。结果2例病例中1例膀胱轻度膨出、膀胱颈移动度增大并尿道旋转角增大及膀胱后角开放、肛门内外括约肌及肛提肌无损伤,诊断为压力性尿失禁、子宫轻度脱垂、肛提肌裂孔面积增大;1例膀胱轻度膨出、膀胱尿道漏斗形成并膀胱后角开放及膀胱颈移动度增大,诊断为压力性尿失禁、肛提肌裂孔面积增大;2例均有临床症状。2例均属轻度病例,航空医学鉴定结论:飞行合格。半年后随访,2例患者行自主Kegel训练或行自主间断Kegel训练及盆底康复理疗半年余,症状明显好转。结论女飞行员盆底功能障碍性疾病应引起重视,早诊断、早治疗、早康复,保障女飞行员身心健康。

Objective To investigate the incidence and related situation of pelvic floor dysfunction in female pilots.Methods The clinical diagnosis,treatment and aeromedical identification of 2 female pilots with pelvic floor dysfunction were retrospectively analyzed.Pelvic floor ultrasound combined with clinical diagnosis was performed and relevant literatures were reviewed.Results One of the 2 cases had mild bladder enlargement,increased bladder neck mobility,increased urethral rotation Angle and cysteine Angle opening,and no damage to internal and external anal sphincter and levator ani muscle,she was diagnosed as pressure urinary incontinence,mild uterine prolapse,and increased hiatus area of levator ani muscle.Another case had mild bladder enlargement,formation of bladder urethral funnel,opening of posterior horn of bladder,and increased mobility of bladder neck,she was diagnosed as pressure urinary incontinence and increased hiatus area of levator ani muscle.Both cases had clinical symptoms and were mild cases.The result of aviation medical identification was qualified for flying.During follow-up,2 pilots received independent Kegel training or intermittent Kegel training and pelvic floor rehabilitation therapy for more than half a year,and the pilots'autonomic symptoms were significantly improved.Conclusions Attention should be paid to the pelvic floor dysfunction of female pilots by early diagnosis,early treatment and early recovery,to ensure the physical and mental health of female pilots.