CAJ | 학술논문

目的：总结飞行人员贫血的病因、诊断、治疗及医学鉴定。方法回顾性分析1993年1月—2013年12月在空军总医院住院的17例飞行人员贫血的病史、诊断分类、治疗经过、疾病转归及医学鉴定。结果缺铁性贫血（iron-deficiency anemia，IDA）6例，失血性贫血2例，IDA合并失血性贫血1例，巨幼细胞贫血（megaloblastic anemia，MA）3例，再生障碍性贫血（aplastic anemia，AA）、β-地中海贫血（轻型）、肺癌合并溶血性贫血（hemolytic anemia，HA）、胸腺瘤合并慢性病贫血（anemia of chronic disease，ACD）、原因未明贫血各1例。IDA、MA、失血性贫血患者经病因治疗贫血均治愈，除1例IDA因地面晕厥飞行不合格、1例MA合并垂体瘤、1例MA合并甲状腺功能亢进飞行暂不合格以外，余均飞行合格；β-地中海贫血（轻型）、原因未明贫血（轻度）各1例未给予治疗，飞行合格；1例AA患者、2例肿瘤合并贫血患者经治疗好转，但飞行不合格。结论飞行人员贫血可由多种原因引起，IDA占大多数，且女性多见，其次为MA、失血性贫血。常见原因有偏食、素食、女性月经过多、痔疮及消化道溃疡出血。多数经治疗痊愈，飞行合格。AA及继发于恶性肿瘤的贫血患者，原则上，一经确诊飞行不合格，治愈者可个别评定。继发于其他良性疾病者，贫血治愈后医学鉴定依原发病治疗结果而定。
목적：총결비행인원빈혈적병인、진단、치료급의학감정。방법회고성분석1993년1월—2013년12월재공군총의원주원적17례비행인원빈혈적병사、진단분류、치료경과、질병전귀급의학감정。결과결철성빈혈（iron-deficiency anemia，IDA）6례，실혈성빈혈2례，IDA합병실혈성빈혈1례，거유세포빈혈（megaloblastic anemia，MA）3례，재생장애성빈혈（aplastic anemia，AA）、β-지중해빈혈（경형）、폐암합병용혈성빈혈（hemolytic anemia，HA）、흉선류합병만성병빈혈（anemia of chronic disease，ACD）、원인미명빈혈각1례。IDA、MA、실혈성빈혈환자경병인치료빈혈균치유，제1례IDA인지면훈궐비행불합격、1례MA합병수체류、1례MA합병갑상선공능항진비행잠불합격이외，여균비행합격；β-지중해빈혈（경형）、원인미명빈혈（경도）각1례미급여치료，비행합격；1례AA환자、2례종류합병빈혈환자경치료호전，단비행불합격。결론비행인원빈혈가유다충원인인기，IDA점대다수，차녀성다견，기차위MA、실혈성빈혈。상견원인유편식、소식、녀성월경과다、치창급소화도궤양출혈。다수경치료전유，비행합격。AA급계발우악성종류적빈혈환자，원칙상，일경학진비행불합격，치유자가개별평정。계발우기타량성질병자，빈혈치유후의학감정의원발병치료결과이정。
ObjectiveTo summarize the etiology, clinical diagnosis, treatment and medical evaluation principles for anemia of aircrew.Methods17 cases of aircrew with anemia, who were hospitalized in Air Force General Hospital from January 1993 to December 2013, were retrospectively analyzed in respect of illness history, clinical diagnosis, therapy, disease outcome and medical evaluation.Results6 cases were diagnosed as Iron deficieny anemia (IDA), 2 cases were hemorrhagic anemia, one case was IDA with hemorrhagic anemia, and 3 cases were megaloblastic anemia(MA). Other 5 cases were, respectively, aplastic anemia (AA),β-thalassemia (minor), lung cancer with hemolytic anemia (HA), thymoma with anemia of chronic disease (ACD), and anemia of unknown cause. IDA, MA and hemorrhagic anemia were cured by etiological treatment, except 1 case with IDA who was not qualified for flying because of ground syncope, 1 MA patient with thymoma and 1 MA patient with hyperthyrea were temporarily grounded; the other IDA, MA and hemorrhagic anemia patients were qualified for flying. Two flying personnel were diagnosed asβ-thalassemia minor and mild anemia of unknown cause were, respectively, qualified for flying without any therapy. One case AA and 2 cases malignant tumor with anemia were alleviated by the primary disease treatment, but they were disqualified to fly.ConclusionsAnemia of flying personnel can be caused by a variety of reasons, in which IDA is the most common, especially among women, followed by MA and hemorrhagic anemia. Common causes are food preferences, vegetarian, female menorrhagia, hemorrhoids and peptic ulcer bleeding. Most of the patients can be cured and qualified for flying. Flying personnel once were diagnosed as AA or anemia secondary to malignant tumor would be disqualified to fly; but if the above mentioned patients were cured, they could be evaluated individually. Anemia secondary to other benign diseases was cured, the medical evaluation wouldbe determined according to the therapeutic outcome of the primary disease.