民航驾驶员甲状腺癌术后的航空医学鉴定研究  

A study on aviation medical identification of thyroid carcinoma in Chinese civil aviation pilots

作　　者：刘子夜 汪庆 杨剑[1] 曹媛[1] 薛玉琳 刘萍[1] LIU Ziye;WANG Qing;YANG Jian;CAO Yuan;XUE Yulin;LIU Ping(Office of Civil Aviation Medicine,Civil Aviation Medicine Center (Civil Aviation General Hospital),Civil Aviation Administration of China,Beijing 100123,China)

机构地区：[1]中国民用航空局民用航空医学中心(民航总医院)航空卫生办公室,北京100123

出　　处：《现代肿瘤医学》2022年第12期2146-2150,共5页Journal of Modern Oncology

基　　金：民航安全能力建设资金(编号:DFS20190602)。

摘　　要：目的:统计2009年至2018年间我国民航驾驶员甲状腺癌发病情况,分析其临床及病理学特点,探讨甲状腺癌术后航空医学鉴定方法及标准。方法:统计2009年至2018年间参加民用航空人员体检鉴定的驾驶员患有甲状腺癌的发病情况,采用回顾性研究方法分析其临床诊治资料。结果:2009年我国民航驾驶员甲状腺癌的发病率为0.40/万,2009年至2018年发病率呈线性增长趋势,2018年发病率增长至2.23/万,增长了5.5倍;民航驾驶员甲状腺癌以男性为主,发病高峰年龄为30~55岁,随着年龄增大甲状腺癌发病率增高;所有人员均接受外科手术治疗,术后病理分型以乳头状癌为主,占96.43%;发生淋巴结转移率为60.71%,淋巴结转移与甲状腺癌大小无明显关系;56例患甲状腺癌的民航驾驶员中,41例特许合格,2例特许不合格,13例未申请特许鉴定,甲状腺癌术后特许合格率为95.35%,甲状腺癌术后整体恢复飞行率为73.21%。结论:民航驾驶员在甲状腺癌结束临床治疗后满一年可申请航空医学鉴定,航空医学鉴定根据临床治愈情况、甲状腺功能、有无肿瘤复发或转移征象、有无术后并发症或后遗症、身体和心理健康情况等方面综合评定。Objective:To investigate the incidence of thyroid carcinoma(TC)in Chinese civil aviation pilots from 2009 to 2018,to analyze the clinical pathological features and explore the chartered identification method and standard.Methods:The medical records of pilots with TC from 2009 to 2018 were reviewed.The concerned data retrospectively included prevalence trend,pathological features,aviation medical results were analysed.Results:The incidence of pilots with TC was 0.40 in ten thousand in 2009,and increased to 2.23 in ten thousand in 2018.There was an increasing trend from 2009 to 2018.Patients were mainly males.Peak onset age was 30~55 years old.The incidence of TC increased with the age increasing.All patients were accepted surgery.The postoperative pathological classification was mainly papillary carcinoma(96.43%).Lymph node metastasis rate was 60.71%,and it had no relation with the size of TC.In 56 TC cases,41 cases were charter qualified,2 cases were charter unqualified,13 cases did not apply for the chartered identification.So the postoperative charter qualified rate of TC was 95.35%and the recovery flying rate was 73.21%.Conclusion:The pilots can apply for the aviation medical identification after the end of clinical treatment for TC about one year.The aviation medical identification requires consideration of the clinical cure,thyroid function,carcinoma recurrence or metastasis,postoperative complications or sequelae,physical and mental health,etc.

关 键 词：甲状腺癌 发病率 航空医学鉴定 驾驶员 

分 类 号：R736.1[医药卫生—肿瘤]