CAJ | 학술논문

目的：初步探讨冠状动脉造影、冠状动脉内超声以及血流储备分数检测对军事飞行人员冠心病医学鉴定的应用价值及意义。方法回顾分析冠状动脉造影、血管内超声以及血流储备分数检测在11例临床诊断军事飞行人员冠心病的应用及其相关医学鉴定情况，评价以上3种检测手段对军事飞行人员冠心病的应用价值。结果11例军事飞行人员，年龄29～52岁，诊断为无症状性心肌缺血4例，心绞痛4例，陈旧性下壁心肌梗死2例，陈旧性前壁心肌梗死1例。11例均在我院行冠状动脉造影术，其中6例同时行冠状动脉造影+血管内超声+压力导丝测定，3例行冠状动脉造影+血管内超声检测，2例行冠状动脉造影+压力导丝测定；其中3例为支架术后复查，有3例经测定后同时行支架植入术，6例为临界病变。飞行结论3例飞行合格，给予放飞，8例飞行暂不合格，地面观察。结论冠状动脉造影结合血管内超声及血流储备分数检测可以从解剖学及功能学上清晰、准确地评估冠状动脉病变，从而为军事飞行人员冠心病的医学鉴定提供更为客观全面的依据。
목적：초보탐토관상동맥조영、관상동맥내초성이급혈류저비분수검측대군사비행인원관심병의학감정적응용개치급의의。방법회고분석관상동맥조영、혈관내초성이급혈류저비분수검측재11례림상진단군사비행인원관심병적응용급기상관의학감정정황，평개이상3충검측수단대군사비행인원관심병적응용개치。결과11례군사비행인원，년령29～52세，진단위무증상성심기결혈4례，심교통4례，진구성하벽심기경사2례，진구성전벽심기경사1례。11례균재아원행관상동맥조영술，기중6례동시행관상동맥조영+혈관내초성+압력도사측정，3례행관상동맥조영+혈관내초성검측，2례행관상동맥조영+압력도사측정；기중3례위지가술후복사，유3례경측정후동시행지가식입술，6례위림계병변。비행결론3례비행합격，급여방비，8례비행잠불합격，지면관찰。결론관상동맥조영결합혈관내초성급혈류저비분수검측가이종해부학급공능학상청석、준학지평고관상동맥병변，종이위군사비행인원관심병적의학감정제공경위객관전면적의거。
ObjectiveTo study the application value of coronary angiogram(CAG) intravascular ultrasound(IVUS) and fractional flow reserve(FFR) for aero-medical assessment of military aircrew with coronary heart disease (CHD). MethodsThe application and aero-medical assessment about 11 military aircrew members diagnosed with CHD who performed with CAG, IVUS and FFR was analyzed retrospectively. The value of the three kinds of detection methods for the application of the CHD military aircrew was evaluated.ResultsAmong 11 aircrew members aged from 29 to 52 years old, including 4 cases with latent coronary heart disease, 4 cases were with angina, 2 cases with old inferior myocardial infarction and 1 case with old myocardial infarction in anterior wall. All of the 11 cases were performed by CAG, including 6 cases performed with CAG and IVUS and FFR simultaneously, 3 cases with CAG and IVUS simultaneously, 2 cases with CAG and FFR simultaneously. There were 3 cases as rechecked after PCI, 6 cases were judged by borderline lesion, 3 cases were performed with percuteneous coronary artery stents after examination. In the end, there were 3 aircrew members qualified to flight, the other 8 aircrew members were disqualified to flight and left in the ground to be observed.Conclusions The method of CAG combined with IVUS and FFR could evaluate the coronary lesion much more distinctly and accurately based on anatomical and functional degree, which could provide objective and comprehensive evidences for medical assessment of military aircrew with CHD.