飞行人员甲状腺疾病的特点、诊治及医学鉴定

目的 总结飞行人员甲状腺疾病的诊治和医学鉴定经验. 方法 收集我院2000年12月-2009年12月间住院飞行人员67例甲状腺疾病资料,将其归为:①无症状的良性甲状腺结节;②慢性淋巴细胞性甲状腺炎;③甲状腺功能异常类疾病(包括甲状腺机能亢进症和甲状腺机能减退症);④甲状腺恶性肿瘤.分析4类疾病的特点及飞行结论 情况. 结果 ①良性甲状腺结节36例(占53.73%),4例手术治疗(腺瘤3例,结节性甲状腺肿1例),除5例因其他原因停飞外,其余31例均飞行合格,定期复查;②慢性淋巴细胞性甲状腺炎5例(占7.46%),甲状腺功能正常,均飞行合格,定期复查;③甲状腺功能异常类疾病20例(占29.85%,甲状腺机能亢进18例,甲状腺机能减退2例),均行药物治疗,6例飞行合格,3例暂时飞行不合格,11例停飞;④甲状腺恶性肿瘤6例(占8.96%,4例为乳头状癌,2例为滤泡状癌),1例飞行合格,5例停飞.经统计学分析,甲状腺功能异常类疾病和甲状腺恶性肿瘤的停飞率均高于良性甲状腺结节和慢性淋巴细胞性甲状腺炎,且差异有统计学意义(P<0.01或P<0.05). 结论 飞行人员甲状腺疾病以无症状的良性结节常见,要重视功能异常类疾病和恶性肿瘤的早期诊断和治疗. Abstract： Objective To summarize the experiences of diagnosis,treatment and medical evaluation of thyroid disease in flying personnel. Methods Sixty-seven cases of thyroid diseases,that were hospitalized from December 2000 to December 2009,were collected and analyzed.They were concluded such categories as:①asymptomatic benign thyroid nodules;②Hashimoto's disease;③diseases of abnormal thyroid functions (including hyperthyroidism and hypothyroidism);and ④thyroid cancer.Their characteristics and the relationship between different categories were analyzed correspondingly to the evaluations for flying. Results ①Among 36 cases of diagnosed asymptomatic benign thyroid nodules (53.73%),4 (3 were adenoma and 1 was nodular goiter) were surgically treated.31 Cases were evaluated as qualified for flying but should be with regular medical check-up while the other 5 were permanently grounded.②There were 5 cases of Hashimoto's disease with normal thyroid functions (7.46%).They were qualified for flying but should be with regular medical check-up.③Thyroid dysfunction took 20 cases (29.85%),among which 18 were hyperthyroidism and 2 were hypothyroidism.Drug treatment was applied.Six cases were finally qualified for flying while the other 3 and 11 were respectively assessed as temporary and permanent grounding.④Six cases were thyroid cancer (8.96%),included 4 papillary carcinoma cases and 2 follicular thyroid carcinoma cases.Only 1 case was finally qualified for flying while the others were permanently grounded.Statistical analysis showed that thyroid dysfunction diseases and thyroid cancer caused significant higher disqualification rate than benign thyroid nodules and Hashimoto's diseases (P<0.01 or P<0.05). Conclusions Benign thyroid nodules are the common thyroid diseases in flying personnel.But the diagnosis of thyroid dysfunction diseases and thyroid malignant tumors should be cared in order to win the chance of treatment and further to reduce the rate of flying disqualification.     

飞行人员甲状腺疾病的特点、诊治及医学鉴定

Objective To summarize the experiences of diagnosis,treatment and medical evaluation of thyroid disease in flying personnel. Methods Sixty-seven cases of thyroid diseases,that were hospitalized from December 2000 to December 2009,were collected and analyzed.They were concluded such categories as:①asymptomatic benign thyroid nodules;②Hashimoto's disease;③diseases of abnormal thyroid functions (including hyperthyroidism and hypothyroidism);and ④thyroid cancer.Their characteristics and the relationship between different categories were analyzed correspondingly to the evaluations for flying. Results ①Among 36 cases of diagnosed asymptomatic benign thyroid nodules (53.73%),4 (3 were adenoma and 1 was nodular goiter) were surgically treated.31 Cases were evaluated as qualified for flying but should be with regular medical check-up while the other 5 were permanently grounded.②There were 5 cases of Hashimoto's disease with normal thyroid functions (7.46%).They were qualified for flying but should be with regular medical check-up.③Thyroid dysfunction took 20 cases (29.85%),among which 18 were hyperthyroidism and 2 were hypothyroidism.Drug treatment was applied.Six cases were finally qualified for flying while the other 3 and 11 were respectively assessed as temporary and permanent grounding.④Six cases were thyroid cancer (8.96%),included 4 papillary carcinoma cases and 2 follicular thyroid carcinoma cases.Only 1 case was finally qualified for flying while the others were permanently grounded.Statistical analysis showed that thyroid dysfunction diseases and thyroid cancer caused significant higher disqualification rate than benign thyroid nodules and Hashimoto's diseases (P<0.01 or P<0.05). Conclusions Benign thyroid nodules are the common thyroid diseases in flying personnel.But the diagnosis of thyroid dysfunction diseases and thyroid malignant tumors should be cared in order to win the chance of treatment and further to reduce the rate of flying disqualification.     

歼(强)击机飞行员心脏瓣膜生理性返流调查分析

Objective To investigate the prevalence of physiological valvular regurgitation and its influence in fighter (attacker) pilots. Methods One hundred pilots were divided into high performance fighter pilot group (56 pilots) and common fighter pilot group (44 pilots). Their cardiac structure and function were examined by echocardiography. Results 55 pilots were diagnosed with physiological valvular regurgitation (55.00%), including 32 high performance fighter pilots (57.14%) and 23 common fighter pilots (52.27%). The prevalence of tricuspid, mitral and combined valvular regurgitation was 33. 00%, 9.00% and 13.00% respectively. There were 11 cases of mitral combined tricuspid valvular regurgitation, 1 case of tricuspid combined pulmonic valvular regurgitation and 1 ease of tricuspid combined aortic valvular regurgitation. In common fighter pilot group, right ventricular internal dimension (RVID) of the pilots with regurgitation was significantly higher than that of the pilots without regurgitation (t= 1.69, P＜0.05). No other significant differences were observed between groups (P＞0. 05). The cardiac structure and function of 100 pilots were in normal range. Conclusions High prevalence of physiological valvular regurgitation is found in fighter pilots, and in which tricuspid valvular regurgitation takes the highest. It is necessary to further investigate if the fighter pilot's specificity makes the different mechanism of physiological regurgitation from other eareer's and its long-term influence on pilot's cardiac structure and function.     

空勤人员鼻科疾病谱研究

目的 通过分析空勤人员鼻科疾病谱提出飞行人员鼻科疾病的防治建议.方法 对1966-2007年间住院的320名空勤人员的373例次鼻科疾病谱进行对比分析.结果 排在鼻科疾病谱前位的为慢性鼻窦炎鼻息肉、鼻窦气压伤、鼻中隔偏曲、变应性鼻炎、慢性鼻炎、鼻窦囊肿、急性鼻窦炎、鼻腔鼻窦肿瘤和鼻外伤等.飞行合格283人,暂时飞行不合格12人,飞行不合格25人.结论 飞行人员鼻科疾病较常见,且与气压伤的关系密切,应积极治疗Ⅰ类鼻腔鼻窦疾病(地面生活有症状),阻止其向地面生活无症状、飞行中出现鼻窦气压伤和(或)耳气压伤症状的Ⅱ类疾病转化.有效治疗Ⅱ类疾病是降低停飞率的重要措施. Abstract： Objective To suggest the protection of aircrews on the base of analyzing disease spectrum of nasal cavity and sinus. Methods The disease spectrum of nasal cavity and sinus was made by analyzing 373 cases of 320 aircrews who were hospitalized from 1966 to 2007. The medical evaluation was reviewed. Results The top diseases in spectrum were chronic sinusitis and nasal polyp, sinus barosinusitis, deviation of nasal septum, allergic rhinitis, chronic rhinitis, cyst in nasal sinus, acute sinusitis, tumor in nasal cavity and sinus, and nasal injuries. In medical evaluation, 283 aircrews were qualified for flying compared to 12 were temporarily grounded and 25 were permanently grounded. Conclusions The nasal cavity and sinus diseases are common in aircrews and usually character barosinusitis and (or) aural barotrauma. The type Ⅰ nasal cavity and sinus diseases (with symptoms on ground) should be treated in time to prevent their transition to type Ⅱ (no obvious symptoms on ground but with symptoms of sinus barosinusitis and (or) aural barotrauma in flight).Duly treating type Ⅱ nasal cavity and sinus diseases would be the effective measure for reducing aircrew's grounding rate.     

飞行人员空晕病的诊治和医学鉴定

Objective To summarize the clinical features,diagnosis and treatment methods,prevention and control measures,and medical evaluation principles for airsickness in flying personnel. Methods Forty-nine cases of flying personnel with airsickness,who were hospitalized from September of 1976 to July of 2009,were retrospectively analyzed in respect of disease course,etiology or incentive,clinical diagnosis and medical evaluation of airsickness.The relationship between vestibular function status and medical evaluation was also statistically analyzed. Results ① Three of 49 picked cases were diagnosed as primary airsickness while the rest 46 were the secondary that were induced by different causes or incentives.Etiological treatment and vestibular habituation were the primarily treatments for such airsickness.② Among these cases,22 were normal in vestibular nystagmus electroretinogram (VNG) comparing to 27 abnormal cases.③ Sixteen and 33 cases were evaluated as normal and deficient Coriolis acceleration tolerance respectively.④ Eleven flying personnel Were finally qualified while 10 and 28 were temporarily and permanently grounded respectively.Flying personnel with abnormal VNG or with deficient Coriolis acceleration tolerance showed higher grounding rate than those with the normal (χ2=5.584,16.722,P<0.05). Conclusions Airsickness in active service flying personnel is mostly the secondary affection,which is caused by various primary disease or incentives.Such prevention and control measures as treating primary disease.eliminating incentives and implementing vestibular habituation are suggested.The effect of airsickness treatment and vestibular function should be emphasized in making medical evaluation.     

空军飞行员飞行错觉后反应分析

目的 掌握现阶段空军飞行员发生飞行错觉后反应状况,以期制定相应对策. 方法 运用"飞行错觉水平量表"对来院疗养的1275名空军飞行员进行飞行错觉问卷调查. 结果 有效量表1221份,飞行错觉总发生率为91.5%,发生错觉后看仪表不能克服的占8.1%,发生错觉后影响操纵的占32.7%,发生了错觉不知道的占6.9%,发生错觉后不能识别周围环境的占1.4%,出现不适症状的占56.6%.歼击机、强击机飞行员飞行错觉后的反应水平明显高于其他机种(P＜0.05).结论 空军飞行员飞行错觉后反应影响飞行安全,急待建立飞行错觉系统训练体系,减少飞行错觉后反应发生,降低飞行错觉反应水平. Abstract： Objective To investigate the Air Force pilots' response to the flight illusion for finding countermeasures. Methods A questionnaire entitled" the level scale of flight illusion" was inquired from 1275 pilots. Results The incidence of flight illusion was 91. 5% by analyzing 1221applicable replies. Among which even 8. 1% pilots could not overcome the illusions by observing instruments. 32.7% pilots reported illusion caused difficulties on aircraft control while 6.9% and 1.4% pilots respectively showed unawareness of illusion and lost the awareness of environment when illusion happened. 56. 6% pilots appeared discomfort. Fighter and attacker pilots showed stronger response than the other type of aircrafts' (P＜0.05). Conclusions Pilot's negative responses to flight illusions have effectively influenced flight safety. It is suggested to build up corresponding training system to control the pilot's negative response to flight illusions.     

多层螺旋CT后处理技术对飞行员腰椎峡部裂的诊断价值

Objective To evaluate the clinical application value of multi-slice CT (MSCT)postprocessing techniques in diagnosing lumbar spondylolysis (LS) of pilots. Methods Three hundred and eighty-five transformed pilots, who were grouped by age (23-28 yr, 29-34yr, 35-40 yr and 41-46 yr) and by flying hours (≤800 h, 801-1600 h and 1601-2400 h), underwent volumetric MSCT scanning in physical examination. Then various postprocessing techniques including multiplanar reconstruction (MPR), maximum intensity projection (MIP) and volume rendering (VR) were carried out at workstation for getting the LS information of pilots. The efficacy of MIP, MPR and VR were compared in diagnosing LS. Results There were 16 cases (at 33 places) of LS in 385 pilots,including 13 bilateral and 3 unilateral LS. Nine cases were accompanied with lumbar spondylolisthesis.The diagnosis rate by MPR images was 100% (33/33), and in which "collar sign of Scottish hound","double articular process sign" and lumbar spondylolisthesis was respectively and clearly revealed on oblique sagittal plane, oblique axial plane and median sagittal plane. MIP images also screened out all LS cases but the viewing of soft tissue was not as good as MPR's. The diagnosis rate by VR imagines was 75. 76% (25/33) but it showed closely to the real anatomy structure of lumbar spine and stereoscopically displayed LS. Conclusions Postprocessing techniques, such as MPR, MIP and VR show good ability in diagnosing spondylolysis and its secondary abnormity. The oblique sagittal (along vertebral arch) and oblique axis (parallel to arch) MPR images are the first choice of reconstruction technique in diagnosing spondylolysis of pilots.     

高性能战斗机飞行员血清铁浓度和红细胞指标变化分析

目的 探讨高性能战斗机飞行员血清铁浓度和红细胞指标变化的机制. 方法 将来我院疗养的39名高性能战斗机飞行员作为观察组,72名歼-7、歼-8和强-5飞行员作为对照组,并比较两组飞行员血清铁浓度、红细胞指标的变化. 结果 高性能战斗机飞行员较对照组飞行员血清铁浓度、血红蛋白量、红细胞平均血红蛋白含量、平均红细胞血红蛋白浓度均降低,且有统计学意义(t=3.50～7.95,P<0.01);而红细胞计数升高,且有统计学意义(t=3.01,P<0.01). 结论 高性能战斗机飞行员因承受较大的加速度、缺氧、热负荷及应激,可能会引起血清铁浓度降低,红细胞计数代偿性升高,从而导致血红蛋白、红细胞平均血红蛋白含量、平均红细胞血红蛋白浓度下降,缺氧耐受力降低.因此.及早采取干预措施,及时减轻飞行疲劳和提高飞行耐力,对于保障飞行安全有重要意义. Abstract： Objective To explore the mechanism of serum iron and red blood cell changes in high performance fighter pilots. Methods Thirty-nine high performance fighter aircraft pilots were selected as test group while other 72 fighter and attacker pilots were in control group.The serum iron and red blood cell index were compared between groups. Results Pilots in test group showed significantly lower serum iron,hemoglobin,mean corpuscular hemoglobin and mean corpuscular hemoglobin concentration than those of other pilots' in control group (t=3.50-7.95,P<0.01) but red blood cell was counted significantly higher (t=3.0 1,P<0.01). Conclusions Changes happened on high performance fighter aircraft pilots indicate that they are undertaking higher working loads such as acceleration,hypoxia.heat and stress.And these would be the reasons of resulting in lower serum iron,higher compensatory red blood cell indices,and lower hemoglobin,mean corpuscular hemoglobin and mean corpuscular hemoglobin concentration,subsequently the poor hypoxia tolerance.Therefore,intervention measures are suggested with timely erythrocyte indices monitoring in order to release fatigue and ensure safety.     

新型载人离心机在军事航空医学中的应用

Objective To investigate the approaches and the application effects of acceleration tolerance screening and training for fighter pilots,-Gx experience,dynamic flight simulation (DFS) experience and physiological evaluation of anti-G equipment on new human centrifuge. Methods ①Twenty-four pilots underwent the relaxed+Gz tolerance examination on a single degree of freedom centrifuge (Model 63) and on new human centrifuge for comparison.②One hundred high performance fighter pilots carried out centrifuge training.Among them,42 pilots were in passive control mode while the other 58 pilots were trained by close-loop mode.③Eight pilots experienced -1.5 Gx and-2.0 Gx on the new centrifuge.④Eighteen pilots performed aerobatic maneuvers,such as left spiral,right spiraI,split S loop,immelmann,and barrel roll in DFS awareness.⑤Six volunteers and 9 pilots served as subjects.The tests of anti-G capability evaluation for suits,suits combined with pressure breathing for G (PBG),and suits combined with PBG and anti-G strainingmaneuver (AGSM) were conducted respectively. Results ①The mean relaxed+Gz tolerance of pilots obtained on the new and old centrifuge was (4.25±0.34) G and (4.41±0.14) G respectively (t=3.03,P<0.01).The difference would be relative to fatigue that caused by continuous running and pilots' endurance to the reduplicate riding.So the current+Gz tolerance screening method was applicable on the new centrifuge regardless of the influence of the above mentioned factors.②In the training under passive control mode,25 of 42 pilots completed the training of 7 G for 10 s,9 pilots for 8 G for 10 s and 2 for 9 G for 10 s.In the close-loop control training,48 pilots passed training of 7 G for 10 s,19 pilots for 8 G for 10 s,and 23 for 9 G for 10 s.③During-Gx experience,the feelings of dizzy and disgust were evident during the roll and pitch movements.④Pilots reported that DFS training was similar to actual flight and possessed great practical value in improving aerial combat ability.⑤The performance of anti-G equipments reached the functional requirement. Conclusions New human centrifuge can be applied in acceleration tolerance screening and training for high performance fighter aircraft pilots,-Gx experience,DFS training,and physiological evaluation for anti-G equipments.Relevant approaches have been established,and the application of new human centrifuge has acquired a satisfactory result.which lays the foundation for further work.     

新型载人离心机在军事航空医学中的应用

目的 探讨在新型载人离心机上进行飞行员抗荷耐力选拔与训练、-Gx体验、动态飞行模拟(dynamic flight simulation,DFS)训练以及抗荷装备生理鉴定实验的方法,探索新型载人离心机的应用方法. 方法 ①24名飞行员在六三型载人离心机上进行基础+Gz耐力检查,然后按同样方法,在新型载人离心机上进行了对照检查.②100名飞行员进行了离心机训练,其中的42名飞行员为被动控制训练,58名飞行员为闭环控制训练.③8名飞行员体验-1.5 Gx及-2.0 Gx载荷.④18名飞行员进行DFS飞行体验,特技飞行动作包括左盘旋、右盘旋、半滚倒转、斤斗、半斤斗翻转和桶滚.⑤6名志愿者和9名飞行员在新型载人离心机上,分别进行服装、PBG、服装结合PBG、服装结合PBG及抗荷收紧动作(anti-G straining manoeuvre,AGSM)的抗荷效果试验. 结果 ①在新、老离心机上检查出的+Gz耐力结果平均值分别为(4.25±0.34)G及(4.41±0.14)G(t=3.03,P<0.01),其差异与连续检查所致的疲劳及飞行员对重复检查的主观重视程度有关,排除二者影响,在新离心机上可采用现有抗荷耐力选拔方法.②在进行被动控制训练的飞行员中,25人完成7 G持续10 s,9人完成8 G持续10 s,仅有2人完成9 G持续10 s.在进行闭环控制训练的58名飞行员中,48人完成7 G持续10 s,19人完成8 G持续10 s,23人完成9 G持续10 s.③飞行员在进行-Gx载荷体验时,反映在座舱俯仰、滚转过程中头晕、恶心的感觉比较明显.④飞行员认为DFS体验与实际飞行接近,对提高机动空战能力具有实用价值.⑤抗荷装备的抗荷性能达到了飞机性能的要求.结论 新型载人离心机在高性能战斗机飞行员抗荷耐力选拔训练、-Gx体验、DFS体验及抗荷装备生理鉴定试验等工作中获得广泛应用,形成了相关应用方法,取得了较好的效果,为进一步开展相关工作奠定了基础. Abstract： Objective To investigate the approaches and the application effects of acceleration tolerance screening and training for fighter pilots,-Gx experience,dynamic flight simulation (DFS) experience and physiological evaluation of anti-G equipment on new human centrifuge. Methods ①Twenty-four pilots underwent the relaxed+Gz tolerance examination on a single degree of freedom centrifuge (Model 63) and on new human centrifuge for comparison.②One hundred high performance fighter pilots carried out centrifuge training.Among them,42 pilots were in passive control mode while the other 58 pilots were trained by close-loop mode.③Eight pilots experienced -1.5 Gx and-2.0 Gx on the new centrifuge.④Eighteen pilots performed aerobatic maneuvers,such as left spiral,right spiraI,split S loop,immelmann,and barrel roll in DFS awareness.⑤Six volunteers and 9 pilots served as subjects.The tests of anti-G capability evaluation for suits,suits combined with pressure breathing for G (PBG),and suits combined with PBG and anti-G strainingmaneuver (AGSM) were conducted respectively. Results ①The mean relaxed+Gz tolerance of pilots obtained on the new and old centrifuge was (4.25±0.34) G and (4.41±0.14) G respectively (t=3.03,P<0.01).The difference would be relative to fatigue that caused by continuous running and pilots' endurance to the reduplicate riding.So the current+Gz tolerance screening method was applicable on the new centrifuge regardless of the influence of the above mentioned factors.②In the training under passive control mode,25 of 42 pilots completed the training of 7 G for 10 s,9 pilots for 8 G for 10 s and 2 for 9 G for 10 s.In the close-loop control training,48 pilots passed training of 7 G for 10 s,19 pilots for 8 G for 10 s,and 23 for 9 G for 10 s.③During-Gx experience,the feelings of dizzy and disgust were evident during the roll and pitch movements.④Pilots reported that DFS training was similar to actual flight and possessed great practical value in improving aerial combat ability.⑤The performance of anti-G equipments reached the functional requirement. Conclusions New human centrifuge can be applied in acceleration tolerance screening and training for high performance fighter aircraft pilots,-Gx experience,DFS training,and physiological evaluation for anti-G equipments.Relevant approaches have been established,and the application of new human centrifuge has acquired a satisfactory result.which lays the foundation for further work.     

Hearing in military pilots: one-time audiometry in pilots of fighters, transports, and helicopters

INTRODUCTION: Pilots are exposed to potentially harmful levels of noise, the actual consequences of which are still poorly documented. We have determined the audiometric profiles of pilots as a function of age and type of aircraft (i.e., fighter, transport, helicopter) and have searched for risk factors of deafness other than noise in a pilot population. METHODS: We examined 521 French military pilots ages 20-40 yr during their annual medical check-ups. Pilots were interviewed using a standardized questionnaire and data from tonal audiograms of both ears were collected. Hearing levels were compared between groups of age and aircraft category. RESULTS: Abnormal hearing levels in pilots were found essentially at high frequencies with a marked notch on audiograms at 6 kHz. Left ears had a significantly poorer performance compared with right ears. At a given age, transport pilots had, on average, better hearing at 8 kHz than other pilots, despite a higher number of flying hours. In addition to the 6 kHz notch, helicopter pilots showed a significant hearing loss at 3 kHz. Such an enlargement of the impaired frequency range can disturb speech communication. Prevalence of otitis media in childhood was significantly higher in pilots with abnormal hearing. DISCUSSION: Pilots flying fighter and helicopter aircraft are at a higher risk of hearing loss compared with pilots flying transport aircraft. Improvements in ear protection seem particularly needed for the left ear. Hearing losses can potentially compromise speech communication in helicopter pilots.     

飞行员肾脏疾病九例的医学鉴定并文献复习

目的 探讨飞行员肾脏疾病的发病特点、诊疗经验以及医学鉴定原则,提出应对策略.方法回顾性分析2005年6月至2008年5月3年间我科收治的9例飞行员肾脏疾病患者的资料和在此期间收治的住院飞行员病历. 结果 ①9例飞行员均为青壮年男性,年龄25～40岁.飞行员肾脏疾病主要分3类:原发性肾小球疾病、先天性尿路畸形和肾结石.②3年问检出各类肾脏疾病占同期本科住院飞行人员总人次的14.9‰.其中,原发性肾小球疾病4例,先天性尿路畸形3例,肾结石4例,有2例飞行员同时患有2种肾脏疾病.③原发性肾小球疾病停飞率高;成人期诊断的先天性尿路畸形多不严重,不影响肾功能者飞行合格;肾结石排出后飞行合格,稳定的肾结石无症状者双座机飞行合格,活动性肾结石飞行不合格.9例飞行员肾脏疾病患者,飞行不合格2例,均为肾小球肾炎患者(其中1例合并肾结石);飞行暂时不合格2例,1例为肾病综合征患者,1例为单纯肾结石患者;其余5例飞行合格,其中2例肾结石患者限双座机飞行. 结论 原发性肾小球疾病、先天性尿路畸形及肾结石在飞行员中均多见,对飞行安全有一定影响,应引起重视并加强相关研究.     

G-induced visual and cognitive disturbances in a survey of 65 operational fighter pilots

INTRODUCTION: Only one previous study has assessed almost loss of consciousness (A-LOC) in operational fighter pilots, reporting an incidence rate of 14%. Research also indicates that 8-13% of pilots have experienced G-induced loss of consciousness (G-LOC). A-LOC can be as insidious as G-LOC due to the associated altered state of awareness and relative incapacitation time, making it a significant risk factor in the high +Gz environment. Royal Australian Air Force (RAAF) pilots currently fly the F/A-18 and Hawk 127, producing +Gz accelerations up to +7.5 Gz, which places these pilots at risk of both A-LOC and G-LOC. METHODS: A survey was administered to 100 active RAAF fighter pilots requesting information on G-induced visual and cognitive disturbances, A-LOC symptoms, and G-LOC. Details regarding type of aircraft, flying maneuvers performed and mission outcome were also sought. RESULTS: There were 65 RAAF fighter pilots who completed the survey (age 20-53 yr, height 168-193 cm, weight 64-110 kg, jet hours 30-5700 h). Of these pilots, 98% indicated they had experienced at least one visual or cognitive disturbance in the high G environment: gray-out 98%; black-out 29%; and A-LOC symptoms 52%, including abnormal sensation in limbs, disorientation, and confusion. There were 9% who indicated they had experienced G-LOC (50% were the pilot flying the aircraft). DISCUSSION: These findings indicate that RAAF fighter pilots are experiencing a similar rate of visual disturbances and G-LOC when compared with other air forces. However, RAAF pilots reported a much higher incidence of A-LOC compared with the only other study of operational fighter pilots.     

Thoracolumbar pain among fighter pilots.

High +Gz forces place high stress on the spinal column, and fighter pilots flying high-performance fighter aircraft frequently] report work-related thoracic and lumbar spine pain. The aim of this study was to determine whether +Gz exposure causes work-related thoracolumbar spine pain among fighter pilots. A questionnaire was used to establish the occurrence of thoracic and lumbar spine pain during the preceding 12 months and during duties over the whole working career among 320 fighter pilots and 283 nonflying controls matched for age and sex. Thirty-two percent of the pilots and 19% of the controls had experienced pain in the thoracic spine during the preceding 12 months (odds ratio [OR] = 2.3; 95% confidence interval [CI] = 1.5-3.5; p = 0.002 for the pilots). Among the pilots, the OR increased up to 6.1 (95% CI = 1.6-23.1; p = 0.0007) with the number of +Gz flight hours. There was no difference between the groups with regard to lumbar pain during the preceding 12 months, but over their whole working careers fighter pilots (58%) had experienced lumbar pain during their duties more often than controls (48%) (OR = 1.8; 95% CI = 1.3-2.6; p = 0.002). The greater the number of +Gz flight hours, the greater the occurrence of lumbar spine pain when on duty (OR = 26.9; 95% CI = 6.2-116; p = 0.0001 for the most experienced fighter pilots). The same was not true with regard to the number of +Gz flight hours and lumbar pain during the preceding 12 months. Age had no effect on pain in the thoracic or lumbar spine. Fighter pilots flying high-performance aircraft have more work-related thoracic and lumbar spine pain than controls of the same age and sex. The difference is explained by the pilots' exposure to +Gz forces.     

高性能战斗机飞行员选拔体检结果分析

目的 了解当前歼击机飞行员身体状况,进一步搞好高性能战斗机飞行员航空卫生保障工作.方法 对55名歼击机飞行员进行全面的临床体检和离心机 Gz耐力检查,确定飞行结论,并对结果进行统计分析比较.结果 ①飞行合格者45人,占总人数的81.8%;飞行不合格者10人,占总人数的18.2%,其中加速度耐力不良7人,外科疾病2人,耳鼻喉科疾病1人.②心电图异常、脂肪肝及脊柱疾患的检出率较高.有21.8%的飞行员加速度耐力低下.结论 要进一步加强飞行员各级体检工作,在招飞体检中加强脊柱疾患的检查,杜绝患有活动性疾病飞行员在队飞行,重点防治心血管疾病.要制定高 Gz抗荷训练方案,以提高歼击机飞行员 Gz耐力.     

Surgical correction of disc pathology in fighter pilots: a review of 14 cases

BACKGROUND: Disorders of the spine are common in fighter crewmembers. The high cost of training and experience for pilots makes it important to use all reasonable clinical means to restore grounded pilots to their flying duties, provided that all safety standards are maintained. To date, there has been limited research into specific surgical treatment of spine injury in pilots. This study was designed to examine the efficacy of surgical procedures in Spanish Air Force fighter pilots with injuries to the spine, as well as the aeromedical disposition of such pilots. METHODS: A retrospective study was conducted using the medical records of 14 fighter pilots with symptomatic spinal disorders treated by surgery. RESULTS: The 14 pilots underwent surgery: 12 cases involved fusion of vertebral structures (arthrodesis), while 2 pilots underwent discectomy. All pilots were subsequently given waivers to resume flying duties. DISCUSSION: The successful return to flight status of these pilots indicates the practical application of surgical techniques that safely stabilize the spine. However, due the sample limited size of the sample, further studies are needed.     

Will they fly again? The probability of wounded military aviators returning to flying duty: a study of 70 cases

In this study, 70 Israeli Air Force aviators, most of them suffering from severe or moderately-severe injuries, were evaluated as to their potential to return to active flying duty. Of these, 59 (84%) were able to return to flying and 11 (16%) were permanently grounded. While 44 of 51 fighter aviators (86%) returned to flying, only 30 of them (59%) returned to fly fighters, and the rest were transferred to another type of aircraft. The roles of age and severity of injury were studied in detail and it was concluded that higher age and severe injuries prolong the convalescence period but do not prevent the aviator from returning to flying. Nine aviators were permanently grounded because of medical reasons. In each case a single injury could be demonstrated as the direct cause of their permanent grounding. All aviators were followed-up for 3 years after having returned to flying. It was concluded that an evaluation period of 2 years is sufficient to determine the long-term success of military aviators returning to flying.     

高性能战斗机飞行员医学选拔若干问题探讨

目的 探讨高性能战斗机飞行员医学选拔中存在的问题，为选拔合格的高性能战斗机飞行员提供依据和指导。方法 采用询问病史、全面体检和综合评价的方法，对214例低机种歼击机飞行员体检发现的问题进行评价。结果 在参选低机种歼击机飞行员中，高性能战斗机改装合格192例，改装不合格并原机种合格，19例，原机种不合格3例。结论 飞行员基本身体状况、基础飞行耐力和加速度耐力是高性能战斗机飞行员的选拔评价重点。     

军事飞行学员医学停飞疾病谱分析

目的 总结分析空军某航空大学近年军事飞行学员医学停飞病征（疾病或体征）特点,为今后军事飞行学员医学选拔和医学鉴定提供客观依据. 方法 对近年空军航空大学医学停飞的614名飞行学员按照所患疾病或病征及病征所隶属体检科室（专业）进行分类统计. 结果 614名医学停飞学员共涉及病征90余种.飞行学员停飞病征排前10位的是视力不足超标、血压超标、频发心律失常、外伤（骨折）、腰椎间盘病变、鼻中隔偏曲、慢性鼻窦炎、胆囊息肉、晕厥及其他心电图异常.医学停飞病征所涉及体检科室（专业）排序依次为眼科、内科、外科、耳鼻喉科、神经内科、心电图检查、超声检查、放射科检查和检验科检查,其中以眼科和内科病征为主,分别占全部医学停飞病征的50.00％、14.86％. 结论 导致在校军事飞行学员医学停飞的主要病征是视力不足超标、血压超标.针对飞行人员职业特点,普及航空医学教育,加强卫生监督,加强可变的功能性病征的矫治、训练,采取积极保护性的干预和心理疏导等措施,对降低在校飞行学员的医学停飞率,提高军事飞行学员的成才率具有重要意义.     

海军飞行人员住院疾病谱及停飞疾病谱分析

目的 分析2001-2006年海军飞行人员住院和医学停飞的主要疾病构成及其变迁特点,并对突出问题提出对策建议.方法 对2001-2006年海军总医院收治的飞行人员全部病例和2001-2006年海军飞行人员医学停飞的全部资料进行统计分析,并同以往不同时期海军飞行人员主要疾病和医学停飞疾病资料进行对比研究.结果 ①飞行人员颈椎腰椎疾病明显增多,其疾病构成比达19.1%,医学停飞构成比达140.0%,均位居第1位;②头痛、自主神经功能紊乱等功能性疾病仍然是飞行人员住院和医学停飞的主要原因之一,疾病构成比分别为18.3%与11.3%,医学停飞构成比分别为11.0%与10.0%;③晕厥(包括加速度耐力性晕厥),在住院疾病构成比仅为4.2%,但其医学停飞构成比达13.0%;④消化系统疾病和传染性疾病无论是住院还是医学停飞构成比均逐渐降低,排序亦逐渐靠后,但出现个别性传播性疾病值得重视.结论 飞行人员住院和医学停飞主要疾病与飞行职业因素密切相关,针对飞行人员的职业特点采取合理锻炼和有效装备防护,积极心理学干预和心血管疾病预防等措施,对降低飞行人员患病率和医学停飞率具有重要意义.