军事飞行员房间隔分流诊治的单中心回顾研究

A single-center retrospective study of atrial septal shunt in military pilots

目的通过超声心动图联合多种影像学方法评估军事飞行员存在的心房水平分流,为飞行员人群的诊治提供依据。方法回顾性分析2013年1月~2021年6月在空军军医大学空军特色医学中心存在心房水平分流[卵圆孔未闭(patent foramen ovale,PFO)或房间隔缺损(atrial septal defects,ASD)]的军事飞行员的病案资料,包括超声心动图和其他影像学诊断方法及临床处置方案,总结分析此类飞行员影像学资料及临床诊治情况。结果共21例心房水平分流的军事飞行员纳入研究,包括单纯PFO7例,继发型ASD11例,原发型ASD1例,PFO伴发ASD2例。对15例飞行员行介入封堵治疗,5例PFO进行随访观察,1例原发型ASD的飞行员进行房间隔修补及二尖瓣成形术;所有飞行员于地面观察及复查后均予以鉴定飞行合格。结论军事飞行员中存在一定比例的心房水平分流,及时通过影像学手段诊断房间隔分流并进行介入封堵是一种有效的治疗手段;但是对于PFO的飞行人员是否需要进行封堵还需进一步深入研究。

AIM To evaluate the presence of atrial septal shunt in military pilots by echocardiography combined with other imaging methods and to provide diagnostic and treatment evidence for military pilots with atrial septal shunt.METHODS The medical records of military pilots with atrial septal shunt,including patent foramen ovale(PFO)or atrial septal defect(ASD)in our hospital from January 2013 to June 2021,were retrospectively analyzed.The imaging diagnostic methods,clinical treatment plan,imaging data and clinical diagnosis and treatment of those pilots were summarized and analyzed.RESULTS There were 21 military pilots with atrial septal shunt,including 7 pilots with PFO alone,11 pilots with secondary ASD,1 pilot with original ASD and 2 pilots with PFO and ASD.Five pilots with PFO were followed up,one pilot with original ASD underwent atrial septal repair and mitral valvoplasty,and the rest were treated with interventional closure.All pilots were qualified for flying after ground observation and review.CONCLUSION There is a certain proportion of atrial septal shunt in military pilots.Timely diagnosis of atrial septal shunt using imaging methods and interventional closure therapy are an effective treatment.However,further research is needed to determine whether pilots with PFO need to be intervened.