7例飞行人员垂体瘤临床资料分析及航空医学鉴定  

Medical evaluation of pituitary tumors in seven aircrews

作　　者：刘晶[1] 郑军[1] 刘红巾[1] 熊巍[1] 付兆君[1] 崔丽[1] 

机构地区：[1]空军总医院全军临床航空医学中心,北京100142

出　　处：《空军医学杂志》2017年第5期293-295,共3页Medical Journal of Air Force

摘　　要：目的探讨飞行人员垂体瘤的临床诊治及航空医学鉴定原则。方法收集空军总医院2003—2015年间收治的7例垂体瘤飞行人员临床诊治和医学鉴定资料,复习国内外相关文献。结果 4例垂体大腺瘤均有头痛症状,头颅MRI显示视交叉受压,其中2例出现视功能异常,1例查体有手足鼻唇肢端肥大伴生长激素水平升高,1例泌乳素水平升高,3例微腺瘤无头痛症状,视交叉未受压,1例有溢乳症状伴泌乳素水平升高。2例行手术治疗,1例拒绝手术,现均已停飞;2例泌乳素瘤经溴隐亭治疗有效后恢复飞行;2例无症状体征的微腺瘤飞行合格。放飞4例。结论患垂体瘤的飞行人员,应进行内分泌、神经、视功能评估,依据病情、治疗效果、飞行机种、飞行职务等进行医学鉴定:(1)出现明显临床表现者飞行不合格;(2)体检发现的无症状、无功能障碍者飞行合格;(3)下列情况个别评定:经手术治疗症状消失、无并发症者;泌乳素瘤服用药物治疗症状缓解,激素水平恢复正常且无药物不良反应者。Objective To investigate the clinical diagnosis and aviation medical evaluation principles of pituitary tumors in aircrews. Methods Data on diagnosis and medical assessment of pituitary tumors in seven aircrews admitted to our hospital between 2003 and 2015 was retrospectively analyzed and related literature was reviewed. Results Four cases of pituitary macroadenomas had a headache and the optic chiasm was abutted, as was shown on cranial MRI. Besides, two of them had abnormal visual function, one had signs of acromegaly, and one had hyperprolactinemia. Another three cases of pituitary macroadenomas had no headache and no abutting optic chiasm, and one of them had galactorrhea accompanied by hyperprolactinemia. Two patients of macroadenomas received surgery and one refused, all of whom were grounded permanently. Two cases of prolactinoma were treated with bromocriptine effectively and were given qualification later. Two cases of microadenomas without any symptoms or signs were given flying qualification, so did two cases of prolactinoma after being treated with bromocriptine effectively. Conclusion Aircrews with pituitary tumors should be subjected to endocrinological, neurological and ophthalmological assessment. Medical evaluation should be based on the state of illness, therapeutic effect, aircraft types and flying duties. It is recommended that aircrews with obvious symptoms and signs of pituitary tumors should be dsqualified; those with incidentally-found, asymptomatic and nonfunctional pituitary tumors should be given qualification; aircrews with pituitary tumors treated surgically and without complications, and cases of prolactinoma treated with drugs effectively and without any side effect should be evaluated individually. Aircrews who are specially permitted to fly should be closely followed up.

关 键 词：航空医学 飞行人员 垂体瘤 

分 类 号：R856[医药卫生—航空、航天与航海医学]