飞行人员年度体检和特殊体检鼻窦炎和鼻窦囊肿的比较分析

目的比较飞行人员年度体检（又称大体检）和特殊体检（如航天员临床医学选拔）鼻窦炎和鼻窦囊肿的特点，为规范飞行人员鼻科体检方法提供依据。方法回顾分析9312名飞行人员疗养大体检（大体检组）、151名飞行员特殊体检（特殊体检组）的鼻科体检资料。大体检时依据病史行鼻镜检查，必要时行鼻窦数字化摄影（digital radiography，DR）检查；特殊体检鼻科体检时，全部行鼻窦CT扫描。对两组人员患鼻窦炎和鼻窦囊肿的资料进行对比分析。结果①大体检组飞行人员中，鼻窦炎170例，占1．8％（170／9312）；需要治疗者90例，占1．0％（90／9312）。特殊体检组飞行员中，鼻窦炎22例，占14．6％（22／151）；需要治疗者2例，占1．3％（2／151）。②大体检组飞行人员中，鼻窦囊肿112例，占1．2％（112／9312）；特殊体检组飞行员中，鼻窦囊肿18例，占11．9％（18／151），囊肿均无需治疗。③大体检组鼻窦炎、鼻窦囊肿的检出率均低于特殊体检组（X^2-120．11、125．98，P〈0．01）；但鼻窦炎需要治疗者，两组所占比例没有显著差异。结论飞行人员疗养大体检鼻科检查时，依据病史行鼻镜和鼻内镜检查，必要时行鼻窦X线、CT等影像学检查可满足诊断需求；但特殊体检鼻科检查时，应全部行鼻窦CT扫描，才能满足诊断和医学鉴定需求。

Comparative analysis of the detections between flying personnel's annual and special physical examination on diagnosing sinusitis and sinus cyst

Objective To compare the detection effects between annual physical examination and the special examination (eg.clinical screening for astronaut) for flying personnel on diagnosing sinusitis and sinus cyst and to provide reference for standardizing nasal examination. Methods The medical data of annual physical examination group and special examination group,where contained 9312 and 151 cases respectively,were reviewed and the detection of sinusitis and sinus cyst was compared.In annual physical examination,nasal endoscopy and digital radiography (DR) were applied if necessary while CT scan was used in special nasal examination. Results ① In annual physical examination group,there were 1.8％ sinusitis cases (170/9312) and 1.0％ (90/9312) cases needed treatment.In special physical examination group,sinusitis cases took 14.6％ (22/151) and 1.3％ (2/151) cases needed treatment.② Sinus cysts case was accounted for 1.2％ (112/9312) in annual physical examination group,comparing with 11.9 ％ ( 18/151) in special physical examination group.No treatment needed for all sinus cyst cases.③ The detection rate of sinusitis and sinus cyst was lower in annual physical examination group than that in special physical examination group (x2 =120.11,125.98,P＜0.01),but the cases of no treating need sinusitis were not significantly different between two groups. Conclusions In annual physical examination,the sinusitis and sinus cyst would be detected by means of rhino-scope or nasal endoscope,even sinus X-ray and CT scan if necessary based on medical history checking.However,in special physical examination CT scan is indispensable for diagnosis and medical evaluation.