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目的总结飞行人员贫血的病因、诊断、治疗及医学鉴定。方法回顾性分析1993年1月—2013年12月在空军总医院住院的17例飞行人员贫血的病史、诊断分类、治疗经过、疾病转归及医学鉴定。结果缺铁性贫血(iron-deficiency anemia,IDA)6例,失血性贫血2例,IDA合并失血性贫血1例,巨幼细胞贫血(megaloblastic a n e m i a,M A)3例,再生障碍性贫血(a p l a s t i c a n e m i a,A A)、β-地中海贫血(轻型)、肺癌合并溶血性贫血(hemolytic anemia,HA)、胸腺瘤合并慢性病贫血(anemia of chronic disease,ACD)、原因未明贫血各1例。I D A、M A、失血性贫血患者经病因治疗贫血均治愈,除1例I D A因地面晕厥飞行不合格、1例M A合并垂体瘤、1例MA合并甲状腺功能亢进飞行暂不合格以外,余均飞行合格;β-地中海贫血(轻型)、原因未明贫血(轻度)各1例未给予治疗,飞行合格;1例AA患者、2例肿瘤合并贫血患者经治疗好转,但飞行不合格。结论飞行人员贫血可由多种原因引起,IDA占大多数,且女性多见,其次为MA、失血性贫血。常见原因有偏食、素食、女性月经过多、痔疮及消化道溃疡出血。多数经治疗痊愈,飞行合格。AA及继发于恶性肿瘤的贫血患者,原则上,一经确诊飞行不合格,治愈者可个别评定。继发于其他良性疾病者,贫血治愈后医学鉴定依原发病治疗结果而定。
Objective To summarize the etiopathogenisis, diagnosis, treatment and medical identification of flight crew anemia. Methods A retrospective analysis was conducted on the history, diagnosis, classification, treatment, disease outcome and medical evaluation of 17 pilots who were hospitalized in the PLA General Hospital from January 1993 to December 2013. Results Six cases of iron-deficiency anemia (IDA), two cases of hemorrhagic anemia, one case of IDA combined with hemorrhagic anemia, three cases of megaloblastic anemia (MA), three cases of aplastic anemia AA), β-thalassemia (mild), hemolytic anemia (HA), and thymoma with anemia of chronic disease (ACD). Patients with IDA, MA and hemorrhagic anemia were all cured by etiological treatment of anemia. Except for 1 case of IDA due to ground faint flight failure, 1 case of MA with pituitary tumor and 1 case of MA complicated with hyperthyroidism, ; β-thalassemia (light), one case of unexplained anemia (mild) without treatment and flight qualification; one case of AA patients, two cases of tumor with anemia were treated but the flight failed. Conclusion Anemia can be caused by a variety of reasons, IDA accounts for the majority, and more common in women, followed by MA, hemorrhagic anemia. Common causes of partial eclipse, vegetarian, women, menorrhagia, hemorrhoids and peptic ulcer bleeding. Most recovered after treatment, the flight qualified. AA and anemia secondary to malignant tumors, in principle, once the diagnosis of unacceptable flight, the cure can be individually assessed. Secondary to other benign diseases, medical treatment of anemia after cure depends on the treatment of primary disease may be.