CAJ | 학술논문

目的探讨飞行人员先天性心脏病的诊断治疗及医学鉴定.方法回顾性分析1993年1月-2010年10月在我院住院的12例飞行人员先天性心脏病病例的临床特点、预后及其医学鉴定结论.结果 12例中:①3例室间隔缺损,2例主动脉二瓣畸形,1例冠状动脉-肺动脉瘘,均未作特殊处理,鉴定结论:飞行不合格.②1例卵圆孔未闭,空中机械师,未作特殊处理,鉴定结论:飞行合格;1例主动脉瓣二瓣畸形,未作特殊处理,鉴定结论:原机种合格.③1例房间隔缺损,外科修补后,鉴定结论:飞行不合格.④1例动脉导管未闭及2例房间隔缺损,均给予介入封堵治疗.其中1例动脉导管未闭及1例房间隔缺损患者经过6～14月地面观察及严格体检后,鉴定结论:飞行合格;另1例房间隔缺损患者尚处于地面观察期,鉴定结论:暂时飞行不合格.结论飞行人员确诊先天性心脏病后,应结合临床分型、飞行机种及预后处理,进行个体化医学鉴定;封堵介入方法治疗先天性心脏病,创伤小,成功率高,治愈患者可考虑重新放飞.
목적 탐토비행인원선천성심장병적진단치료급의학감정.방법 회고성분석1993년1월-2010년10월재아원주원적12례비행인원선천성심장병병례적림상특점、예후급기의학감정결론.결과 12례중:①3례실간격결손,2례주동맥이판기형,1례관상동맥-폐동맥루,균미작특수처리,감정결론:비행불합격.②1례란원공미폐,공중궤계사,미작특수처리,감정결론:비행합격;1례주동맥판이판기형,미작특수처리,감정결론:원궤충합격.③1례방간격결손,외과수보후,감정결론:비행불합격.④1례동맥도관미폐급2례방간격결손,균급여개입봉도치료.기중1례동맥도관미폐급1례방간격결손환자경과6～14월지면관찰급엄격체검후,감정결론:비행합격;령1례방간격결손환자상처우지면관찰기,감정결론:잠시비행불합격.결론 비행인원학진선천성심장병후,응결합림상분형、비행궤충급예후처리,진행개체화의학감정;봉도개입방법치료선천성심장병,창상소,성공솔고,치유환자가고필중신방비.
Objective To study the diagnosis and treatment of congenital heart disease (CHD) in flying personnel as well as the medical assessment to them. Methods The disease characteristics, prognosis and medical assessment for the 12 flying personnel with CHD, who were hospitalized in Air Force General Hospital from 1993 to 2010, were reviewed. Results Diagnosis and medical assessments showed that: ① There were 3 ventricular septal defect (VSD) cases, 2 bicuspid aortic valve deformity cases and 1 coronary artery fistula case. All of them did not receive any special surgical treatment and were disqualified for flying eventually. ② A aerial engineer was diagnosed as foramen ovale open (PFO) and he was eventually qualified. One bicuspid aortic valve deformity case was assessed as qualified for the flying for his original aircraft type. ③ There was 1 atrial septal defect (ASD) case. Even he received surgical repair successfully, but was still disqualified eventually. ④ There were 1 patent ductus arteriosus (PDA) case and 2 ASD cases that received medical interventional closure. In 6 to 14 months period of temporary grounding period, the pilot with PDA and one pilot with ASD were closely followed-up and passed strict medical examinations. They were qualified for flying eventually. But another ASD pilot was still in observation and temporary grounded. Conclusions Once flying personnel is diagnosed as CHD, doctors should give individual assessment upon clinical symptom, type of aircraft and prognosis. Occluder interventional therapy for CHD is safe and effective. The recovered flying personnel by successful treatment could be considered to return flying.