军事飞行人员神经外科住院疾病分析及航空医学鉴定

Analysis on the diseases of neurosurgery in hospitalized military flying personnel and aeromedical assessment

目的通过分析神经外科住院军事飞行人员疾病特点,为疾病诊治及航空医学鉴定提供参考依据。方法收集空军特色医学中心神经外科2010—2020年收治的56例军事飞行人员的病例资料,回顾性分析军事飞行人员职别、飞行机种、诊断、治疗方案及航空医学鉴定结论。结果军事飞行人员所患神经外科疾病按照疾病谱构成比大小,依次为脑血管病(35.71%)、中枢神经系统肿瘤(17.86%)、鞍区病变(17.86%)、蛛网膜囊肿(16.07%)、颅脑损伤(5.36%)、头皮肿物(3.57%)及脊髓空洞症(3.57%)。20例脑血管疾病患者中5例经手术治疗,其余15例保守治疗;鉴定结论为飞行合格或限定合格10例,暂时飞行不合格9例,飞行不合格1例。10例中枢神经系统肿瘤患者中5例手术治疗,1例放射治疗,4例保守治疗;鉴定结论为飞行合格或限定合格3例,暂时飞行不合格3例,飞行不合格4例。10例鞍区病变患者中2例手术治疗,3例药物治疗,其余5例随访观察;鉴定结论为飞行合格或限定合格8例,暂时飞行不合格1例,飞行不合格1例。9例蛛网膜囊肿患者中,1例手术治疗,8例保守治疗;鉴定结论为飞行合格或限定合格5例,暂时飞行不合格1例,飞行不合格3例。其余7例患者中,药物治疗或观察5例,手术治疗2例;鉴定结论为飞行合格6例,暂时飞行不合格1例。结论神经外科疾病在军事飞行人员中亟需引起更多重视,部分人员因此疾病导致限定合格、暂时飞行不合格甚至飞行不合格。

Objective To provide references for disease diagnosis,treatment and aeromedical assessment by analyzing the characteristics of neurosurgical diseases in hospitalized military flying personnel.Methods The case data and aeromedical assessment conclusions of 56 military flying personnel admitted to the Neurosurgery Department of Air Force Medical Center from 2010 to 2020 were collected.The diagnosis and treatment,as well as the flight post and aircraft type were retrospectively analyzed against the assessment conclusions.Results The constituent ratio descending order of the neurosurgical diseases in the flying personnel was cerebrovascular disease(35.71%),central nervous system tumors(17.86%),sellar lesions(17.86%),arachnoid cysts(16.07%),traumatic brain injury(5.36%),scalp tumors(3.57%)and syringomyelia(3.57%)respectively.Among the 20 patients with cerebrovascular diseases,5 received surgical treatment and other 15 received conservative treatment.In which 10 cases were qualified or restricted qualified,9 cases were temporarily grounded,and 1 case was disqualified for flight.Among the 10 cases with central nervous system tumor,5 received surgical treatment,1 received radiotherapy and 4 received conservative treatment.In which 3 cases were qualified or restricted qualified,3 cases were temporarily grounded and 4 cases were disqualified for flight.Among the 10 cases with saddle area lesions,2 received surgical treatment,3 received medical treatment and other 5 were observed by followed up.In which 8 cases were qualified or restricted qualified,1 was temporarily grounded and 1 was disqualified for flight.Among the 9 cases with arachnoid cysts,1 received surgical treatment and 8 received conservative treatment.In which 5 cases were qualified or restricted qualified,1 was temporarily grounded and 3 were disqualified for flight.Among the other 7 cases,5 received medical treatment or observed by follow-up,and 2 received surgical treatment.In which 6 cases were qualified for flight and 1 was temporarily grounded.Conclusions Neurosurgical diseases should be paid more for flight safety due to quite a few restricted qualified,temperedly grounding or disqualified cases existed in the military flying personnel with such diseases.