空军医学杂志
空軍醫學雜誌
공군의학잡지
MEDICAL JOURNAL OF AIR FORCE
2014年
1期
5-7,14
,共4页
刘静%薛梅%韩冬梅%丁丽%郑晓丽%闫洪敏%王志东%朱玲%董磊%王永奇%王恒湘
劉靜%薛梅%韓鼕梅%丁麗%鄭曉麗%閆洪敏%王誌東%硃玲%董磊%王永奇%王恆湘
류정%설매%한동매%정려%정효려%염홍민%왕지동%주령%동뢰%왕영기%왕항상
血小板减少症%诊断%医学鉴定%飞行人员
血小闆減少癥%診斷%醫學鑒定%飛行人員
혈소판감소증%진단%의학감정%비행인원
Thrombocytopenia%Diagnosis%Medical evaluation%Aircrew
目的：总结飞行人员血小板减少症的病因诊断、治疗及医学鉴定。方法回顾性分析我院收治的14例飞行人员血小板减少症患者的病史、诊断分类及治疗经过，疾病转归及医学鉴定。结果14例中9例为原发免疫性血小板减少症（ITP），获得性低巨核细胞性血小板减少性紫癜（AATP）、继发性血小板减少症、脾功能亢进、原因不明的一过性血小板减少症、EDTA依赖性假性血小板减少症（EDTA-PTCP）各1例。9例ITP经治疗7例治愈，2例好转，仅1例暂时飞行不合格，其余8例均飞行合格；1例AATP患者好转，飞行合格；1例原因不明的一过性血小板减少症及1例EDTA-PTCP患者飞行合格。1例治愈的继发性血小板减少症患者，因其他疾病飞行不合格；1例脾功能亢进患者飞行不合格。结论飞行人员血小板减少可由多种原因引起，ITP占大多数，多数经治疗痊愈，飞行合格。少数是血小板生成不良、继发因素及假性血小板减少所致。继发因素所致血小板减少医学鉴定依原发病治疗结果而定。
目的：總結飛行人員血小闆減少癥的病因診斷、治療及醫學鑒定。方法迴顧性分析我院收治的14例飛行人員血小闆減少癥患者的病史、診斷分類及治療經過，疾病轉歸及醫學鑒定。結果14例中9例為原髮免疫性血小闆減少癥（ITP），穫得性低巨覈細胞性血小闆減少性紫癜（AATP）、繼髮性血小闆減少癥、脾功能亢進、原因不明的一過性血小闆減少癥、EDTA依賴性假性血小闆減少癥（EDTA-PTCP）各1例。9例ITP經治療7例治愈，2例好轉，僅1例暫時飛行不閤格，其餘8例均飛行閤格；1例AATP患者好轉，飛行閤格；1例原因不明的一過性血小闆減少癥及1例EDTA-PTCP患者飛行閤格。1例治愈的繼髮性血小闆減少癥患者，因其他疾病飛行不閤格；1例脾功能亢進患者飛行不閤格。結論飛行人員血小闆減少可由多種原因引起，ITP佔大多數，多數經治療痊愈，飛行閤格。少數是血小闆生成不良、繼髮因素及假性血小闆減少所緻。繼髮因素所緻血小闆減少醫學鑒定依原髮病治療結果而定。
목적：총결비행인원혈소판감소증적병인진단、치료급의학감정。방법회고성분석아원수치적14례비행인원혈소판감소증환자적병사、진단분류급치료경과，질병전귀급의학감정。결과14례중9례위원발면역성혈소판감소증（ITP），획득성저거핵세포성혈소판감소성자전（AATP）、계발성혈소판감소증、비공능항진、원인불명적일과성혈소판감소증、EDTA의뢰성가성혈소판감소증（EDTA-PTCP）각1례。9례ITP경치료7례치유，2례호전，부1례잠시비행불합격，기여8례균비행합격；1례AATP환자호전，비행합격；1례원인불명적일과성혈소판감소증급1례EDTA-PTCP환자비행합격。1례치유적계발성혈소판감소증환자，인기타질병비행불합격；1례비공능항진환자비행불합격。결론비행인원혈소판감소가유다충원인인기，ITP점대다수，다수경치료전유，비행합격。소수시혈소판생성불량、계발인소급가성혈소판감소소치。계발인소소치혈소판감소의학감정의원발병치료결과이정。
ObjectiveWe tried to summarize the clinical diagnosis , treatment and medical evaluation principles for thrombocytopenia in flying personnel.Methods14 cases of flying personnel with thrombocytopenia,who were hospitalized in Air Force General Hospital from January 1993 to January 2013,were retrospectively analyzed in respect of illness history, clinical diagnosis, therapy, disease outcome and medical evaluation.Results9 of 14 cases were diagnosed as primary immune thrombocytopenia (ITP), other 5 cases acquired low megakaryocytic thrombocytopenic purpura (AATP), secondary thrombocytopenia, hypersplenism, unexplained transient thrombocytopenia and EDTA-dependent pseudothrombocytopenia(EDTA-PTCP)respectively. In 9 cases with ITP, 7 cases were cured, 2 cases improved. 8 cases were finally qualified for flying, only 1 case was temporarily grounded.1 case with AATP was improved and qualified for flying. 1 case with unexplained transient thrombocytopenia and 1 case with EDTA-PTCP were also qualified for flying. 1 case with secondary thrombocytopenia was cured but was permanently grounded due to other diseases. 1 case with hypersplenism was also permanently grounded.ConclusionsThrombocytopenia in flying personnel can be caused by a variety of reasons, in which ITP is the most frequent reason. Most of the patients were cured and qualified for flying. The minority of thrombocytopenia can be caused by poor platelet production, secondary factors and pseudothrombocytopenia. Medical evaluation for thrombocytopenia caused by secondary factors is determined according to the outcome of the primary disease.
