摘要
目的分析三维可视化技术在军事飞行人员肝内胆管结石腹腔镜肝切除术应用中的安全性、有效性, 并探讨该病的航空医学鉴定。方法回顾性分析空军特色医学中心2021年12月收治的1例患肝内胆管结石军事飞行人员的诊疗过程及航空医学鉴定结论, 结合新技术进展进行文献复习。结果本例患者系陆航直升机空中机械师, 男性, 40岁, 检出胆囊结石12年, 肝内胆管结石8年, 间断右上腹痛3月余。B超及CT检查示胆囊多发结石、肝右后叶肝内胆管结石伴胆管扩张。行肝脏三维可视化技术指导下腹腔镜肝Ⅵ段精准切除、胆囊切除、胆总管探查取石和T管引流术。术后6个月复查, 恢复良好, 航空医学鉴定结论:特许飞行合格。截止投稿日已安全飞行50 h。结论三维可视化技术指导下的腹腔镜解剖性肝切除术治疗军事飞行人员肝内胆管结石, 安全性好, 效果佳, 术后恢复良好者可特许飞行合格。
Objective To investigate the safety and effectiveness of the laparoscopic hepatectomy guided by three-dimensional visualization technology for treating hepatolithiasis in military flying personnel and to discuss the aeromedical assessment.Methods The diagnosis and treatment of a military flying personnel with hepatolithiasis admitted to the Air Force Medical Center in December of 2021 and the conclusions of aeromedical assessment were analyzed.The literature was reviewed in combination with the progress of new technologies.Results This case,a 40-year-old male helicopter aerial machinist,had been found gallbladder stones for 12 years,hepatolithiasis for 8 years,and intermittent right upper abdominal pain for more than 3 months.Ultrasound and CT examination showed multiple gallbladder stones,intrahepatic bile duct stones in the right posterior lobe of the liver with bile duct dilatation.Under the guidance of three-dimensional visualization technology,laparoscopic liver segment 6 precise resection,cholecystectomy,common bile duct exploration and stone removal,and T-tube drainage were performed.The patient was well recovered and waivered to flight after 6 months of the operation.As of the submission date,he has safely flown for 50 h.Conclusions Laparoscopic anatomical hepatectomy guided by three-dimensional visualization technology in the military flying personnel with hepatolithiasis shows good safety and effect,and those who recover well after surgery can be waivered to flight.
作者
刘承利
蒲猛
张书涵
赵旭英
马英博
李浩铭
杨俊
李璐阳
孔令红
崔丽
Liu Chengli;Pu Meng;Zhang Shuhan;Zhao Xuying;Ma Yingbo;Li Haoming;Yang Jun;Li Luyang;Kong Linghong;Cui Li(Department of Hepatobiliary Surgery,Air Force Medical Center,Air Force Medical University,PLA,Beijing 100142,China;Department of Sleep Medicine,Air Force Medical Center,Air Force Medical University,PLA,Beijing 100142,China)
出处
《中华航空航天医学杂志》
2023年第3期144-149,共6页
Chinese Journal of Aerospace Medicine
关键词
结石
胆管
肝内
肝切除术
合格鉴定
三维可视化技术
军事飞行人员
Calculi
Bile ducts,intrahepatic
Hepatectomy
Eligibility determination
3D visualization technology
Military flying personnel
