摘要
目的探讨军事飞行员胆总管结石(common bile duct stones,CBDS)的临床诊疗及航空医学鉴定。方法收集空军特色医学中心2009年6月至2015年3月诊断为CBDS的3例军事飞行员的详细诊疗过程及航空医学鉴定结论,结合新技术进展进行分析。结果3例飞行员因长期胆囊结石或肝内胆管结石,继发CBDS并梗阻性黄疸。病例1:继发于胆囊结石,行腹腔镜胆囊切除术及胆总管探查术,中转开腹行胆总管探查取石;病例2:继发于肝内胆管结石,行开腹肝左外叶切除、胆总管探查取石;病例3:继发于胆囊结石保胆取石术后复发,最终因胆管狭窄行开腹胆囊切除、胆总管整形、T管引流术。3例患者术后均恢复良好。飞行结论:病例1于术后5个月飞行合格;病例2术后因高血压病停飞;病例3于术后半年飞行合格。结论军事飞行员CBDS多继发于胆囊结石或肝内胆管结石,手术应尽早施行,尽量采用微创方法。治疗措施得当、术后恢复良好者可飞行合格。
Objective To explore the clinical diagnosis and treatment of common bile duct stones(CBDS)in military pilots and the aeromedical assessment.Methods The detailed diagnosis and treatment process,as well as the aeromedical assessment of 3 military pilots diagnosed as CBDS in Air Force Medical Center,PLA from June 2009 to March 2015 were collected.Then it was analyzed by the new technology.Results Three pilots were diagnosed as CBDS and obstructive jaundice due to long term cholecystolithiasis or calculus of intrahepatic duct.Case 1 was secondary to cholecystolithiasis,and received laparoscopic cholecystectomy and common bile duct exploration.Case 2 was secondary to intrahepatic cholelithiasis and underwent left lateral lobectomy and common bile duct exploration.Case 3 recurred after cholecystolithotomy and then underwent open cholecystectomy,choledochoplasty and T-tube drainage because of biliary stricture.All 3 cases recovered well.The aeromedical assessment conclusions were as follows:case 1 was qualified to flight 5 months after operation,case 2 was grounded due to hypertension after the operation,case 3 was qualified after 6 months of the operation.Conclusions CBDS of military pilots is often secondary to cholecystolithiasis or intrahepatic bile duct stones.The operation should be performed as early as possible,and minimally invasive methods should be adopted.The pilots with proper treatment and good postoperative recovery can be qualified to flight.
作者
刘承利
蒲猛
王成
孔亚林
戴竞耀
马英博
赵刚
何晓军
孔令红
赵静
肖梅
张辉
Liu Chengli;Pu Meng;Wang Cheng;Kong Yalin;Dai Jingyao;Ma Yingbo;Zhao Gang;He Xiaojun;Kong Linghong;Zhao Jing;Xiao Mei;Zhang Hui(Department of Hepatobilitary Surgery,Air Force Medical Center,PLA,Beijing 100142,China)
出处
《中华航空航天医学杂志》
2021年第1期21-25,共5页
Chinese Journal of Aerospace Medicine
基金
军队后勤“十一五”科技攻关课题(08G047)
全军后勤科研重大项目(AKJ15J003)。
关键词
胆总管结石
合格鉴定
军事飞行员
Choledocholithiasis
Eligibility determination
Military pilots
