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目的通过引入ＣＴ、ＭＲＩ现代医学检查手段，重新评价肾结石的航空医学鉴定观点。对飞行员一经确诊患肾结石，就鉴定为飞行不合格这一“规定”提出置疑。方法通过ＣＴ、ＭＲＩ检查结果，将Ｂ超诊断的肾结石分成肾实质内结石和肾盂结石两类。由于肾实质内结石进入肾盂非常缓慢，引起肾绞痛少，使监护成为可能。中国国际航空公司６名患肾实质内结石的驾驶员，均经航空医学鉴定并放飞作飞行观察。结果对首次确诊肾实质内结石放飞的飞行员，三个月内每周一次尿常规镜检，未发现红细胞和超量结晶。三个月复查一次Ｂ超，未见结石位移，出勤前、后也无不良主诉，年度ＣＴ、ＭＲＩ示肾实质内结石未入肾盂。空中跟班观察，无论国内短距航线，多起落长距航线还是跨洲际长时长距航线，均未发现患肾实质内结石飞行员在空中发生不适症状及主诉。无影响飞行操纵的失能表现，经每年２～３次的跟班观察，证明飞行员肾实质内结石发生肾绞痛的可能较小。结论肾髓质区的结石不会引起肾绞痛，而突入肾盂或输尿管的结石易引起绞痛。肾实质内结石的诊断只有ＣＴ、ＭＲＩ可准确定位。对肾实质内结石航空医学鉴定结论为Ⅳ类观察飞行合格。只有航医、体检医师和飞行员共同对肾实质内结石重视，才能使观察飞行合格的鉴定结论真正?
Objective To introduce the modern medical examination methods of CT and MRI to reassess the viewpoint of aviation medicine identification of kidney stones. Once the pilot is diagnosed with kidney stones, he is challenged to be identified as a “non-compliance” flight. Methods By CT, MRI examination results, the diagnosis of B-kidney stones are divided into renal parenchymal stones and renal pelvis stones two categories. As the renal parenchyma stones into the renal pelvis is very slow, causing less renal colic, so guardianship possible. Air China 6 patients with pituitary calcification of pilots, were identified by the aviation medicine and let flight for observation. Results For the pilots who were first diagnosed with renal calculi flying within the stones, urinalysis and over-crystallization were not found once a week in the three months. Three months to review a B-ultrasound, no stone displacement, attendance before and after no adverse complaints, the annual CT, MRI showed renal parenchymal stones did not enter the renal pelvis. Observations in the air with the class, regardless of the domestic short-range routes, long-distance multi-long-haul routes or long-haul long routes across the intercontinental, did not find suffering from renal parenchymal pilots in the air and discomfort symptoms and complaints. No effect on flight maneuver disability performance, 2 to 3 times a year follow-up observation that pilots parenchyma stones may be less renal colic. Conclusion The medullary area of the stones will not cause renal colic, and into the renal pelvis or ureter stones easily lead to colic. The diagnosis of renal parenchymal stones only CT, MRI can be accurately located. The conclusions of the aviation medicine identification of renal parenchyma calculi were qualified for class IV flight observation. Only aviation doctors, medical examiners and pilots to attach importance to the stones in the renal parenchyma, in order to make the conclusions of the identification of qualified flight observation really?