一例战斗机飞行员硬膜外血肿清除术后随访12年并文献复习  

twelve-year follow up of a fighter pilot after extradural hematoma removal and literatures review

作　　者：欧阳海鹰[1] 李银喜[1] 董贵安[1] 于传久[1] 费林 张波 

机构地区：[1]解放军昆明疗养院478疗区,昆明650200 [2]东方航空公司云南分公司航卫部,昆明650200

出　　处：《中华航空航天医学杂志》2009年第4期256-259,259,300,共4页Chinese Journal of Aerospace Medicine

摘　　要：目的 探讨外伤致飞行员硬膜外血肿的诊治方案、预后评估. 方法 结合1例男性战斗机飞行员的临床资料及复习文献,对硬脑膜外血肿的发生、诊治及预后进行综合分析. 结果 原歼-6飞行员,因车祸致头部外伤后昏迷,清醒后感头痛、头昏、恶心和呕吐.头颅ct提示:左颞顶部硬膜外血肿.保守治疗3 h病情加重.复查头颅ct示:左颞顶部硬膜外血肿明显增大.全麻下急诊行左颞顶部硬膜外血肿清除术,经综合治疗,临床治愈出院.出院诊断:重型闭合性颅脑损伤,左颞顶部硬脑膜外血肿,左颞顶骨骨折,头皮血肿.后因脑外伤综合征两次住院治疗.复查头颅ct无异常发现.1年半后停飞,转业到民航,2002年在民航开始参与飞行(副驾)空客及波音系列机型至今已6年,一切正常. 结论 根据外伤史、临床症状及头颅ct检查可明确诊断飞行员硬膜外血肿.及时而合理的治疗有利于病情恢复,并可恢复飞行.objective to investigate the treatment plan of a pilot with extradural hematoma (edh) that resulted from trauma and its prognosis assessment. methods based on the clinical record of a male fighter pilot who suffered from edh and reviewed literatures the invasion, treatment and prognosis of edh were analyzed. results a f-6 pilot suffered from coma when his head injured in a traffic accident and then he felt headache, dizziness, nausea and vomiting when his consciousness recovered. head computerized tomography (ct) showed that the edh was at left temporal-parietal. as the condition became worse in 3 h expectant treatment the edh was removed by operation. then he recovered by comprehensive treatment and discharged. clinical record was read as severe closed craniocerebral injury, the edh at the left temporal-parietal, left temporal-parietal bone fractures and scalp hematoma. subsequently he had hospitalized twice due to the diagnosis of brain trauma syndrome but no abnormalities were found by head ct examinations. he failed to have military flying certificate 18 months later and transferred to civil airline. he had served as a copilot of airbus and boeing series aircraft since 2002 and no more abnormalities were found within 6 years. conclusions the pilot's edh might be definitely diagnosed with the reference of trauma history, clinical symptoms and head ct scan. timely and proper treatment would be helpful to pilot's edh recovery and would be good to continue his flying career.

关 键 词：事故 交通 血肿 硬膜外 颅内 合格鉴定 

分 类 号：R651.15[医药卫生—外科学]