飞行人员鼓膜破裂的特点及对航空航天飞行的影响

目的探讨飞行人员鼓膜破裂的特点及对航空航天飞行的影响。方法分析20例23耳飞行人员鼓膜破裂的病例。结果气压损伤所致4例5耳、外伤致鼓膜破裂各4例4耳,化脓性中耳炎致鼓膜破裂12例14耳;1例永久停飞,2例飞行暂不合格,17例飞行合格。结论鼓膜破裂可影响航空航天飞行,而航空航天飞行也可引起鼓膜破裂。     

飞行人员变应性鼻炎的特点及对飞行的影响

目的 探讨变应性鼻炎和航空航天飞行的关系。方法 总结分析飞行人员变应性鼻炎资料３２份。结果 ３２例中常年性鼻炎２０人,季节性变应性鼻炎１２人。２６例继续飞行,６例永久停飞。结论 变应性鼻炎可影响航空航天飞行;航空航天飞行也可诱发或加重变应性鼻炎。     

飞行人员无症状脑梗死的研究现状与进展

目的 综述国内外飞行人员无症状脑梗死（asymptomatic cerebral infarcts,ACI）的研究现状和进展. 资料来源与选择 国内外公开发表的相关文献. 资料引用 引用文献资料36篇. 资料综合 ACI在飞行人员中具有较高的发生率.除了一般血管危险因素,飞行高度和机型等飞行因素也与ACI相关.低压、高G值载荷、飞行中滞动及右向左分流等是造成ACI的主要原因.由于缺乏ACI的航空医学鉴定标准,飞行人员ACI的医学鉴定通常参照症状性脑血管病的标准.结论 飞行人员ACI不仅与常见血管危险因素有关,还受诸多飞行因素的影响.解决飞行人员ACI的治疗、预防和飞行适应性评价等问题,需要开展ACI预后观察、综合防治及飞行适应性评价研究.     

Phobic fear of flying in aircrews: epidemiological aspects and comorbidity

BACKGROUND: Phobic fear of flying may affect aircrew members during any phase of their flying careers. Symptoms are beyond voluntary control and may lead patients to avoid flying and seek medical advice. METHODS: Of 1101 psychiatric files from our institute for 1985-2002, 150 represented cases of fliers who suffered from phobic fear of flying. Data collected from those files included assessment of fear-evoking situations, type of aircraft, class of aircrew duties, aircraft accident history, past medical history, age, and associated psychiatric comorbidity. RESULTS: We compared a group of 56 pilots with 94 other aircrew members. Results included 143 cases of flight phobia behavior and 7 cases of anxiety about parachuting. Flight phobia was less frequent among pilots (37.4%) than the other aircrew members (62.6%). We found a history of aircraft accident to the patient or an acquaintance in 25% of the cases. Observed comorbid psychiatric disorders (54%) consisted of depressive disorders (22%), anxiety disorders (16%), and personality disorders (7.4%). Fixed-wing pilots and aircrews members had a higher incidence of depression than did rotary-wing pilots and crewmembers (p < 0.05). Rotary-wing pilots and crewmembers had a higher rate of anxiety disorders (p < 0.05). DISCUSSION: Flight phobia encompasses a wide spectrum of clinical origins that may lead pilots or other aircrew members to refuse to fly. We recommend a careful psychiatric evaluation and close follow-up to adequately diagnose fliers with flight phobic reactions, as well as establishing adequate medical and/or psychological treatment.     

飞行中人体的呼吸生理反应

本文系统地回顾了飞行中飞行人员呼吸生理反应的研究进展，包括高性能飞机飞行时的呼吸生理反应，飞行中的附加呼吸阻力及能量消耗问题，飞行人员的通气过度反应等。对每一项呼吸生理反应均讨论了其飞行中的生理监测及军用标准问题，并给出了有代表性的数据资料。文中还讨论了高性能战斗机飞行时的呼吸生理反应及其监测问题。     

飞行人员合理用药飞行安全性评价方法和指标体系

目的 回顾与分析国内外有关飞行人员合理用药飞行安全性评价的研究资料,提出相关的评价方法和指标体系.资料来源与选择 国内外相关研究论文、综述和专著.资料引用论文及综述66篇,专著6部.资料综合 基于飞行人员合理用药对飞行工作能力影响评价的研究文献作者所采用的方法和指标,对资料进行分析、综合.结论 提出了军事飞行人员合理用药飞行安全性评价的主要方法和指标体系,对制定飞行人员合理用药方案、确保飞行安全具有重要意义.     

饮食和运动干预治疗飞行人员高血压病的临床效果

目的：评价饮食和运动干预治疗飞行人员高血压病的临床疗效。方法：将41高血压病飞行人员分配到治疗组（28例）和对照组（13例），治疗组接受严格的饮食和中等强度运动干预治疗，对照组则接受口服硝苯地平10－20mg,3次／d治疗，测量两组飞行人员入组时，1个月后、2个月后和1年后的血压、体重指数、腰臀比、血脂和血液流变学相关指标。结果：经过1年严格的饮食和运动干预后，治疗组在1个月、2个月和1年后体重指数、腰臀比、总胆固醇、载脂蛋白B、甘油三酯、低密度脂蛋白胆固醇和血液流变学相关指标低于对照组（P＜0．01），但对照组血压的降低出现在1个月左右，而治疗组则出现在2个月左右，随访1年后发现治疗组高血压病复发率低于对照组（P＜0．05）。结论：长期严格的饮食和中等强度运动干预能降低高血压病飞行人员的体重指数、腰臀比和血压水平，并纠正血脂代谢紊乱，降低高血压病复发率。     

飞行人员梅尼埃病的特点

目的探讨飞行人员梅尼埃病的特点及对航空航天飞行的影响。方法总结飞行人员梅尼埃病资料２２份。结果２２例表典型的眩晕发作,２１例耳鸣,１９例有听力下降,１１例前庭功能异常,结论梅尼埃病可能危及航空航天安全,航空航天可能加重梅尼埃病的内耳损害。     

Treatment of hypertension in aviators: a clinical trial with Aldactazide

Thirty-two USAF aircrewmen with mild or moderate, uncomplicated essential hypertension were treated with Aldactazide (spironolactone and hydrochlorothiazide). The study was designed to determine the efficacy and safety of this drug combination in aircrew subject to the stress of flying high-performance aircraft. All patients were investigated in detail before, and again 6 weeks after, beginning Aldactazide treatment. Adequate blood pressure control was achieved in 94% of patients; 84% were able to return to flying duties. Treatment was associated with a moderate loss of weight and plasma volume, and a slight reduction in renal function. Tolerance to multiple stress tests was unimpaired after treatment. Symptoms attributable to treatment were minimal. We conclude that in the dose used, four tablets or less daily, Aldactazide is a safe and fairly effective secondline treatment for hypertensive aircrewmen.     

航空性额窦炎与航空航天飞行

目的探讨航空性额窦炎与航空航天飞行的关系.方法分析飞行人员航空性额窦炎临床资料31份.结果左侧病变17例,右侧病变2例,双侧9例,病历中未记录侧别的3例.合并有航空性中耳炎者6例、筛窦炎和/或上颌窦炎者22例、鼻中隔偏曲者11例、鼻甲肥大者10例.24例飞行合格,4例飞行暂不合格,3例飞行不合格.结论航空性额窦炎可因疼痛、流泪和视物模糊而危及航空航天飞行安全;航空航天飞行也能诱发或加重航空性额窦炎.     

陆军和空军飞行人员飞行合格的医学鉴定分析

目的提供我国陆军和空军飞行人员医学放飞的流行病学资料。方法回顾近年患病飞行人员的住院病历。结果患病住院飞行人员21.8%飞行合格,其中心脏病科占18.4%,耳鼻喉科14.9%,神经病科12.3%,胃肠病科9.6%。结论膝关节病变、泌尿系结石、航空性鼻窦炎经过治疗后放飞的可能性最大。飞行员放飞比例低于通讯员,其停飞可能性是后者的4.97倍。     

Prevalence of the metabolic syndrome in military and civilian flying personnel

BACKGROUND: The metabolic syndrome (MS) affects 20-30% of the middle-aged population in highly industrialized countries, consisting of a cluster of diseases including obesity, hypertension, dyslipoproteinemia and glucose intolerance. HYPOTHESIS: If the population of flying personnel (FP) faces a high risk to develop MS, due to the specific workload of specialized aircrew, the consequences for aeromedical screening are to be reconsidered. METHODS: Data of the complete military flying personnel (MFP) of Germany were screened to develop MS-related risk factors, regular physical activity and determination of nicotin and alcohol consumption. A comparable screening of a population of German civilian flying personnel (CFP) was undertaken by questionnaire. Statistics were completed by comparison of averages by t-test for independent random-samples of different variances and testing of independence of single characteristics by chi2-test. RESULTS: Data of approximately 10,000 aircrew members were obtained. It was possible to determine a group of MFP with higher risk to develop MS later in life, called "possible future metabolics" (PFM). Comparison of PFM with the MFP control group (MCG) and CFP clearly showed that obesity, dyslipoproteinemia and hypertension are the main single and/or combined risk factors. As a new aspect, data of MFP showed possible connections between thyroideal dysfunction and the prevalence of relevant MS-risk factors. CONCLUSIONS: The purpose of this investigation was to determine the actual risk of MS in German FP and to confirm the current MS-related regular screening measures. This study revealed that German MFP and CFP show a high quality health status without significant differences between both groups. Continuing the current regular flight medical screening will prevent FP from losing its high quality health status.     

Contact lenses and corrective flying spectacles in military aircrew--implications for flight safety

BACKGROUND: Refractive devices used by aviators need to suit the aerospace environment or their failure can have serious implications. A relatively minor visual disability can result in loss of life and aircraft. We surveyed commonly occurring problems with the different types of refractive correction worn by Royal Air Force (RAF) aircrew over the previous 12 mo. We also asked if they had experienced any flight safety incidents (FSI) relating to their refractive correction. METHODS: A retrospective anonymous questionnaire survey was given to 700 active aircrew occupationally graded as requiring corrective flying spectacles (CFS) or contact lenses (CL) for flying. RESULTS: 63% (443) of the questionnaires were completed. CL were worn by 53% of aircrew; 71% of them used daily disposable CL. CFS were worn by the remaining 47% of aircrew, 14% of whom used multifocal lenses. Of CFS wearers, 83% reported problems including misting, moving, discomfort, and conflict with helmet-mounted devices (HMD). CL-related ocular symptoms were reported in 67% of wearers including cloudy vision, dry eye, photophobia, red eyes, excessive mucus formation, CL movement, itching, and grittiness. No CL-related FSI were reported over the previous 12 mo compared with 5% CFS-related FSI (p < 0.001). The graded performance of CL for vision, comfort, handling, convenience, and overall satisfaction was significantly higher than for CFS. CONCLUSION: CFS are associated with problems in terms of comfort and safety. CL are well tolerated by aircrew, and deliver improved visual performance.     

Low back pain in Norwegian helicopter aircrew

The size and consequences of low back pain (LBP) in Norwegian helicopter aircrew has been investigated in a retrospective and prospective survey. With 50.5% reporting such pain in a 2-yr period, and Sea King aircrew reporting LBP on on almost half (49.3%) of the missions flown, the magnitude of the problem equals that reported from other air forces. Pilots reported LBP six times more often than other crewmembers and almost half (48.6%) felt the pain influenced the quality of work. This could have flight safety implications. Crewmembers with total flying time over 2,000 h have a significantly higher incidence of sick leave than those with less than 2,000 h. Only 1 pilot out of 10 with total flying time under 500 h had had flight-related LBP.     

住院飞行人员疾病谱分析

目的总结我院空勤科住院飞行人员疾病谱的特点,为新时期航卫保障提供参考依据。方法收集2006年1月—2012年12月住院飞行人员的病历资料,对其疾病谱进行分析研究。结果 326例住院飞行人员疾病谱分布较广,排在前5位的是上呼吸道感染、自主神经功能紊乱、神经性头痛、颈椎病、腰椎间盘突出。年龄分布在前3位的是25～29岁,30～34岁,35～39岁。医学鉴定结论为飞行合格250例,暂时不合格76例。结论住院飞行人员疾病谱,从一定程度上反映了本地区飞行人员从疾病、年龄到医学鉴定结论的分布特点,这对指导飞行部队航医有针对性地加强疾病的防范有重要意义。     

飞行人(学)员鼻科疾病诊治和医学鉴定规范

目的 规范飞行人(学)员鼻科疾病诊断、治疗和医学鉴定行为,提高航卫保障质量.方法 分析我院40年飞行人(学)员鼻科疾病住院资料,借鉴国内外该领域的研究成果,总结笔者的临床航空医学经验,提出统一的操作规范.结果 ①飞行人员人(学)员鼻科疾病的诊断分为急性和慢性[包括慢性鼻-鼻窦炎(不伴鼻息肉)和慢性鼻-鼻窦炎(伴鼻息肉)],Ⅰ类(地面生活有症状或体征,包括Ia地面生活有症状和体征,Ib仅有体征)和Ⅱ类(地面生活无症状,飞行中出现气压伤表现,包括Ⅱa鼻窦气压伤、Ⅱb耳气压伤和Ⅱc鼻窦气压伤合并耳气压伤);鼻窦气压伤分为原发性(窦口本身病变所致)和继发性(窦口周围病变所致,包括I型-鼻腔结构异常型、Ⅱ型-炎症型、Ⅲ型-变态反应型、Ⅳ型-肿瘤型,窦外型和窦内型),及轻度和重度.②飞行人(学)员鼻科疾病应根据急慢性、分类分型和分度特点及有无并发症采用无创或微创治疗.③飞行人(学)员鼻科疾病应根据疗效、功能检查(包括鼻窦气压功能)进行医学鉴定.结论 按规范进行飞行人(学)员鼻科疾病诊断、治疗和医学鉴定,可以降低停飞率,提高复飞率.     

飞行人员尿石症临床特点和医学鉴定

目的研究飞行人员尿石症的临床特点，提高对飞行人员尿石症的防治和医学鉴定水平。方法对48例飞行人员尿石症患者（35例恢复飞行患者）随访资料进行回顾性分析。结果飞行人员尿石症的临床特点是大多起病急、症状典型、结石小、并发症少和治疗效果佳。35例（72．9％）一次住院治愈。2例（4．2％）病情反复发作伴其他疾病，予以停飞。随访的35例资料中1例患者次年复发门诊治愈；4例准予带石飞行者，均无空中肾绞痛发作。结论飞行人员尿石症必须及时送院、积极治疗，以缩短住院和地面观察时间，恢复飞行。带石飞行的标准应严格控制，以确保飞行安全。     

Polycystic kidney disease and the flyer

Polycystic kidney disease (PKD) is a disorder occasionally detected in aircrew members. Complications associated with PKD include hypertension, urinary tract infections and calculi, and cerebral or abdominal aneurysms with the most frequent cause of death, uremia and renal failure. The prognosis for PKD is variable in that it is a benign disorder for some patients whereas others are fraught with these complications. Many airmen with PKD can continue with cockpit duties as long as there are no potentially incapacitating symptoms. Of particular importance is good blood pressure control for those with hypertension.     

The Aviation Psychology Program at RAF Upper Heyford

An Aviation Psychology Program was started in September, 1985 at RAF Upper Heyford, with the focus on teaching flight commanders and their wives to recognize and deal with aircrew member and family stress. The overall goal is to prevent aircraft accidents and mishaps caused by human factor errors. Case reports are presented which demonstrate the value of the aviation psychologist becoming integrated in the flying community. The program has been successful, but needs further commitment and support.     

SSRI effects on pyschomotor performance: assessment of citalopram and escitalopram on normal subjects

INTRODUCTION: Standard aeromedical doctrine dictates that aircrew receiving treatment for depression are grounded during treatment and follow-up observation, generally amounting to at least 1 yr. The Canadian Forces has initiated a program to return selected aircrew being treated for depression to restricted flying duties once stabilized on an approved antidepressant with resolution of depression. The currently approved medications are sertraline (a selective serotonin reuptake inhibitor) and bupropion (noradrenaline and dopamine reuptake inhibitor). This study was undertaken to determine whether or not citalopram or escitalopram affect psychomotor performance. METHOD: In a double-blind crossover protocol with counter-balanced treatment order, 24 normal volunteer subjects (14 men and 10 women) were assessed for psychomotor performance during placebo, citalopram (40 mg), and escitalopram (20 mg) treatment. Each treatment arm lasted 2 wk, involving a daily morning ingestion of one capsule. There was a 1-wk washout period between medication courses. Subjects completed a drug side-effect questionnaire and were tested on three psychomotor test batteries once per week. RESULTS: Neither citalopram nor escitalopram affected serial reaction time, logical reasoning, serial subtraction, multitask, or MacWorth clock task performance. CONCLUSIONS: While we found some of the expected side effects due to citalopram and escitalopram, there was no impact on psychomotor performance. These findings support the possibility of using citalopram and escitalopram for returning aircrew to restricted flight duties (non-tactical flying) under close observation as a maintenance treatment after full resolution of depression.