飞行人员肾脏结石成分分析及健康管理  

Kidney stone composition and health management of aircrew

作　　者：李建业 吴君贤 郭和清 马建军 张蕾 刘兰兰 杨永红 王娜 贾辰龙 仇实 LI Jianye;WU Junxian;GUO Heqing;MA Jianjun;ZHANG Lei;LIU Lanlan;YANG Yonghong;WANG Na;JIA Chenlong;QIU Shi(Department of Urology,Air Force Medical Center,Beijing 100142,China;不详)

机构地区：[1]空军特色医学中心泌尿外科,北京100142 [2]空军特色医学中心医疗科研部,北京100142

出　　处：《空军医学杂志》2020年第5期394-396,共3页Medical Journal of Air Force

基　　金：国家军用标准资助项目(BKJ19B048);全军医学科技青年培育项目(14QNP066)。

摘　　要：目的探讨飞行人员肾脏结石成分分析结果及其复发预防方案。方法回顾分析2015年8月—2019年5月因肾脏结石在空军特色医学中心就诊的27例飞行人员临床资料,经治疗后留取结石标本并行结石成分分析,根据结石分析结果和飞行人员职业特点,制定有针对性的健康管理方案。结果所有患者均为男性,均接受输尿管软镜检查/取石术治疗,其中16例患者软镜下明确发现肾脏结石并将结石取出,11例患者获得明确结石分析报告。9例结石分析结果显示均为草酸钙结石,2例为草酸钙合并碳酸磷灰石。所有飞行人员经治疗后均鉴定飞行合格。根据结石分析结果对所有飞行人员进行以预防草酸钙结石复发为主的健康宣教。观察期间所有患者均安全飞行,其中1例患者复查时见肾脏原有钙斑消失,另有1例患者原有左肾中盏钙斑消失,左肾下盏新发结石1枚,长径约5 mm,返院行输尿管软镜取石术,结石取出并治愈,鉴定飞行合格。结论飞行人员肾脏结石成分以草酸钙为主,要制定以预防草酸钙结石复发为主的健康管理方案。Objective To report the analysis results of kidney stones in the aircrew and explore schemes for recurrence prevention.Methods The clinical data about 27 pilots who were diagnosed with kidney stones between August 2015 and May 2019 was retrospectively analyzed.The stones were collected and analyzed to identify their ingredients.A health management plan based on the results of stone analysis and the occupational characteristics of pilots was developed.Results All these pilots were males and underwent flexible ureteroscopy.The stones were located and taken out of the kidneys of 16 patients and 11 stone analysis reports were obtained which showed that 9 of the stones were calcium oxalate and 2 were calcium oxalate combined with carbonate apatite.All the aircrew were permitted to fly after surgery.Based on the results of stone analysis,all the aircrew were informed of the health management program focused on preventing the regeneration of calcium oxalate stones.During the follow-up,all these pilots flew safely.One pilot's renal papillary calcium spot disappeared as was showed by the CT scan.A second pilot's renal papillary calcium spot in the middle renal calix disappeared but one new 5 mm kidney stone was found in the lower renal calix,so he received a second flexible ureteroscopy before he was permitted to fly.Conclusion Calcium oxalate is the main component of kidney stones in aircrew,and a health management plan based on prevention of the recurrence of calcium oxalate stones should be formulated.

关 键 词：肾脏结石 飞行人员 结石分析 预防 

分 类 号：R856.6[医药卫生—航空、航天与航海医学]