CAJ | 학술논문

目的探讨飞行员小肠憩室的诊断、治疗和医学鉴定,为军事及民航飞行员航空医学鉴定和招飞体检提供依据. 方法分析1例民航飞行员患小肠憩室伴溃疡出血的诊断和治疗；结合文献复习,总结小肠憩室的病理生理特点、临床特征、诊断和治疗. 结果该例民航飞行员经胶囊内镜和双气囊小肠镜检查,明确诊断为小肠憩室伴溃疡出血.经止血、抗感染及加强营养等治疗,成功治愈并放飞.经随访18个月,飞行正常. 结论患小肠憩室及不明原因消化道出血的飞行员,应使用胶囊内镜及双气囊小肠镜检查确诊.小肠憩室若处于静止状态,无需治疗,一般不会影响飞行；小肠憩室合并溃疡出血及感染需进行止血和抗感染等治疗.军事运输机及民航客机飞行员临床治愈,失血纠正,体力恢复,可下飞行合格结论；经内科保守治疗无效或憩室病灶反复出现并发症,要考虑手术治疗,术后根据病情恢复情况,需个别评定.在招飞体检中建议开展常规胶囊内镜检查以了解消化道的情况,从而为招飞对象的选择提供依据.
목적 탐토비행원소장게실적진단、치료화의학감정,위군사급민항비행원항공의학감정화초비체검제공의거. 방법 분석1례민항비행원환소장게실반궤양출혈적진단화치료；결합문헌복습,총결소장게실적병리생리특점、림상특정、진단화치료. 결과 해례민항비행원경효낭내경화쌍기낭소장경검사,명학진단위소장게실반궤양출혈.경지혈、항감염급가강영양등치료,성공치유병방비.경수방18개월,비행정상. 결론 환소장게실급불명원인소화도출혈적비행원,응사용효낭내경급쌍기낭소장경검사학진.소장게실약처우정지상태,무수치료,일반불회영향비행；소장게실합병궤양출혈급감염수진행지혈화항감염등치료.군사운수궤급민항객궤비행원림상치유,실혈규정,체력회복,가하비행합격결론；경내과보수치료무효혹게실병조반복출현병발증,요고필수술치료,술후근거병정회복정황,수개별평정.재초비체검중건의개전상규효낭내경검사이료해소화도적정황,종이위초비대상적선택제공의거.
Objective To explore the diagnosis,treatment and medical assessment of the pilot suffering from small intestine diverticulosis,and provide the reference to aeromedical assessment of military and civil pilots and physical examination of pilot recruitment.Methods A case of civil pilot suffering from small intestine diverticulosis with ulcer bleeding was analyzed.By referring to the literature review,the pathophysiologic features,clinical manifestations,diagnosis and treatments for intestine diverticulosis were summarized.Results The intestine diverticulosis with ulcer bleeding was diagnosed by the capsule endoscopy and double-balloon enteroscopy.With the treatments of hemostasis,anti-infection and the consolidation of dietary nutrition,the pilot was recovered and qualified for flying.18months follow up showed that he was in normal physical condition.Conclusion Pilots suffering from small intestine diverticulosis and obscure gastrointestinal bleeding can be diagnosed by capsule endoscopy and double balloon enteroscopy.If small intestine diverticulosis was in stable,it wouldn't affect flying and treatment wouldn't be required.If small intestine diverticulosis combined with ulcer bleeding and infection,the hemostatic and anti-infection treatments would be required.If small intestine diverticulosis was with ulcer bleeding and had been affected,treatment of hemostasis and anti-infective treatment should be taken.Military transporter pilot and civil pilot can be qualified for flying in case of blood loss stopped and fitness recovered.The surgery should be considered if conservative treatment failed,or recurrent diverticulosis complication appeared.The assessment should be individually issued according to pilot's postoperative recovery.Routine capsule endoscopy examination is recommended due to its effective diagnosis and reference value to the physical examination of pilot recruitment.