民航飞行员颅内动脉瘤介入栓塞术后复飞八例分析及航空医学鉴定标准探讨  

Analysis on 8 qualified cases of civil pilots treated by intracranial aneurysm interventional embolism surgery and discussion on the standard of medical evaluation

作　　者：汪庆 葛泽松 徐开勇[1] 武将 李旭 张超[1] 闫浩 徐恒周 Wang Qing;Ge Zesong;Xu Kaiyong;Wu Jiang;Li Xu;Zhang Chao;Yan Hao;Xu Hengzhou(Civil Aviation Medicine Centre,Beijing 100123,China;Xi'an Hospital of Civil Aviation,CAAC,Xi'an 710082,China)

机构地区：[1]中国民用航空局民航医学中心,北京100123 [2]西安民航医院,710082

出　　处：《中华航空航天医学杂志》2022年第1期35-41,共7页Chinese Journal of Aerospace Medicine

基　　金：民航总医院科研项目基金(201918)。

摘　　要：目的探讨民航飞行员颅内动脉瘤介入栓塞术后的航空医学鉴定标准及随访情况。方法回顾性分析2012年6月至2020年11月8例中国民航飞行员颅内动脉瘤介入栓塞术的临床诊治、特许鉴定和随访情况,并进行国内外文献复习。结果7例动脉瘤患者脑核磁筛查偶然检出8个未破裂动脉瘤,1例因蛛网膜下腔出血检出1个破裂动脉瘤。7例动脉瘤未破裂者术后地面观察1年以上特许鉴定合格,不得履行机长职责和限制飞行小时数(双限制),复飞1年后逐步取消限制,随访4~7年。1例动脉瘤破裂者术后地面观察满2年特许鉴定合格,双限制,复飞1年后因记忆力下降放弃体检鉴定,失访。结论飞行员颅内动脉瘤介入栓塞术后的航空医学鉴定,应充分考虑其主诉、临床特点、影像学表现、脑电图、认知和飞行能力,结合其复飞意愿进行个体化评估,复飞后应长期随访。Objective To explore the aeromedical assessment standard and follow-up situation for the civil pilots treated by intracranial aneurysm interventional embolism surgery.Methods The information about diagnosis and treatment,aeromedical identification and follow-up of 8 pilots treated by intracranial aneurysm interventional embolism surgery from June 2012 to November 2020 were collected and analyzed retrospectively,and relevant literatures were reviewed.Results Eight unruptured aneurysms were detected accidentally in 7 patients during medical examination,and 1 ruptured aneurysm was detected due to subarachnoid hemorrhage.Seven pilots with unruptured aneurysms were waivered for flight after at least 1-year grounding for observation,with the restrictions of limited flying time and barred duty from being a captain(double restrictions).Then the restrictions were gradually cancelled after 1-year waiver and the follow-up was extended for 4-7 years.The pilot with ruptured aneurysms was waivered after 2-year grounded observation with double restrictions.He gave up the aeromedical assessment because of memory loss after returning flight for 1 year and the follow-up was terminated then.Conclusions The aeromedical assessment for the pilot with intracranial aneurysm interventional embolism surgery should consider the objective and clinical characteristics,imaging findings,EEG,cognitive performance,flight ability,as well as the individual assessment upon pilot′s wishes.The pilots who resume flying should be followed up for an extended period.

关 键 词：颅内动脉瘤 栓塞 航空医学 民航飞行员 

分 类 号：R856.74[医药卫生—航空、航天与航海医学]