飞行员肾脏小结石带石飞行初步观察  

The waiver flying consideration of the pilots with kidney stone

作　　者：孙斌[1] 郭和清[1] 李建业[1] 严景民[1] 穆大为[1] 陈元浩[1] 洪泉[1] 崔丽[1] 邹志康[1] 

机构地区：[1]空军总医院,北京,100142

出　　处：《中华航空航天医学杂志》2013年第1期-,共4页Chinese Journal of Aerospace Medicine

基　　金：全军后勤科研"十二五"重大项目

摘　　要：目的 观察飞行因素对肾脏小结石移位的影响,探讨飞行员肾脏小结石特许飞行标准. 方法 回顾性分析2005年9月-2012年6月因肾结石入住空军总医院、经治疗后特许带石飞行的空军17例飞行员临床及随访资料. 结果 患者均为男性,年龄23～46岁,平均34.4岁.左肾结石7例,右肾结石4例,双肾结石6例.单座机飞行员9人,双座机飞行员8人.平均特许飞行时间110 h(30～240 h).所有患者均为经体外冲击波碎石术+药物排石或微创手术综合治疗后仍有残留结石；残石大小2～4 mm,经运动试验后复查CT结石无移位,尿常规红、白细胞数量正常,准予特许飞行.单座机飞行员每3个月复查,双座机飞行员每6个月复查,观察项目包括症状、泌尿系统CT扫描以及尿常规检查.所有患者随访期间均无飞行过程中肾绞痛发作.3例双座机飞行员在地面排石时出现腰部不适,但无绞痛发作,复查CT结石消失；其余14例患者均无症状,定期泌尿系统CT检查提示结石大小、位置无变化,尿常规正常. 结论 肾脏小结石＜4 mm,排石时一般无绞痛发作,飞行因素不影响小结石移位；对结石＜3 mm的飞行员,在严密观察下特许飞行是可行的.Objective To observe the influence of flying on the movement of small kidney stones and to investigate the waiver flying qualification for the pilot with kidney stone.Methods The clinical data of 17 pilots with kidney stone,who were hospitalized from Sep.2005 to Jun.2012,and the fellow-up for their waiver flying were reviewed.Results All pilots were male and the average age was 34.4 yr.(from 23 to 46 yr.).Seven pilots had stones at left kidney,while 4 pilots had at right and 6 pilots had at both sides.All pilots received extracorporeal shock wave lithotripsy (ESWL) and drug or micro-invasive treatments,but there were still small kidney stones (2 to 4 mm in longitudinal diameter) left.No stone movement was found by exercise test and CT scan and the routine urine examination showed normal WBC and RBC numbers.Then they were qualified waiver flying.8 pilots were solely flying and the other 9 were co-piloting.The average waiver flying time was 110 h (from 30-240 h).The 8 were required to recheck in hospital by 3-month period while the 9 by 6-month rechecks,where they were inquired self symptoms and received CT scan and routine urine examination.The fellow-up showed no renal colic happened in air.Three co-piloting pilots complained lumbalis discomfort but colic while the stones were removed out on ground.The CT scan indicated that there were no more stones.There was no discomfort in other 14 pilots.The timely CT scan showed their stones had no change either on size or location and the routine urine examination results were normal.Conclusion The small kidney stone expelling will rarely cause renal colic if its size is less than 4 mm.The flying conditions do not promote the small stone movement in kidney.For the pilots with the kidney stone smaller than 3 mm,the assessment of waiver flying with close follow-up is feasible.

关 键 词：肾结石 合格鉴定 航空 特许飞行 

分 类 号：R[医药卫生]