军事飞行员头颅影像学检查4例典型病例报道并文献复习  

Four typical cases report and literature review of cranial imaging examination in military pilots

作　　者：汪东军 郑军 石进 刘红巾 付兆君 陈大伟 王军 王星 王丽萍 刘启明 WANG Dongjun;ZHENG Jun;SHI Jin;LIU Hongjin;FU Zhaojun;CHEN Dawei;WANG Jun;WANG Xing;WANG Liping;LIU Qiming(Department of Medical Evaluation,Air Force Medical Centre,Beijing 100142,China)

机构地区：[1]空军特色医学中心医学鉴定科,北京100142 [2]空军特色医学中心神经内科,北京100142

出　　处：《空军医学杂志》2022年第1期21-24,共4页Medical Journal of Air Force

基　　金：军队后勤科研计划项目(BKJ16B066)。

摘　　要：目的 通过典型病例报告探讨头颅影像学检查在军事飞行员健康体检及医学鉴定中的应用价值和重要意义。方法回顾分析2019年在空军特色医学中心实施健康体检,通过头颅影像学检查发现的4例军事飞行员病例,复习国内外相关文献,分析飞行人员患颅内占位病变及脑血管疾病的临床特点、处置措施,提出医学鉴定应把握的原则。结果 2例较大蛛网膜囊肿均无症状,脑电图正常,考虑为先天发育异常,其中1例为枕大池囊肿,大小4.6 cm×2.8 cm,结论飞行合格;另1例为左额颞部囊肿,大小9.1 cm×2.8 cm×8.3 cm,结论暂时飞行不合格,建议降为(改为)低载荷机种飞行。第3例为左侧大脑前动脉A2段重度狭窄,脑血管造影显示代偿供血良好,结论飞行合格。第4例为左大脑中动脉血管瘤,大小0.7 cm×0.8 cm,结论暂时飞行不合格,进行手术治疗。结论 目前常规体检难以发现军事飞行员存在的中枢神经系统潜在疾病,有些疾病具有显著的航空医学意义。在健康体检时应用头颅CT、MRI、MRA等影像学检查能及早发现这些疾病,对防止空中突然失能,保障飞行安全具有重要作用。Objective To investigate the applicability and signif icance of cranial imaging examination(CT,CTA,MRI,MRA)in medical checkups and medical evaluation of military pilots via typical case reports.Methods The clinical data on four patients who were fighter pilots and had their diseases detected by cranial imaging examination in 2019 in our medical center was statistically analyzed.Related domestic and foreign literature was reviewed.The clinical characteristics,treatments and the conclusions of f light qualifications were analyzed to recommend the principles of medical identification.Results Two of the 4 cases had larger arachnoid cysts,both asymptomatic and normal in terms of electroencephalograms,so that congenital aplasia was suspected.One of them wasa cisterna magnacyst sized 4.6 cm×2.8 cm,so doctors concluded this pilot was qualified for f lying.The other one was a left frontotemporal cystsized 9.1 cm×2.8 cm×8.3 cm,so this pilot was given qualifications for low performance aircraft.The 3rd case was severe stenosis inthe A2 section of the left anterior cerebral artery,which showed good compensatory blood supply by cerebral angiography,so flying qualifications were issued.The 4th one had left middle cerebral artery hemangioma with a size of 0.7 cm×0.8 cm,and this pilot wastemporarilygrounded for surgical treatment.Conclusion Some of the potential diseases of the central nervous system are difficult to discoverduring routine physical examinationsfor military pilots,which can be identified through cranial imaging examinations.The earliestpossible detection of these diseases may be of great significance for preventing sudden inflight incapacitation and ensuring flight safety.

关 键 词：飞行人员 中枢神经系统疾病 头颅影像学 体格检查 合格鉴定 

分 类 号：R856.74[医药卫生—航空、航天与航海医学]