军事飞行人员角膜屈光手术后视力和屈光变化的随访研究

目的 通过分析军事飞行人员角膜屈光手术后的视力和屈光变化,探讨我军飞行人员实施屈光手术后视功能及屈光的稳定性和军事航空医学关注点.方法 回顾性收集近10年(2012年1月至2021年6月)于空军特色医学中心眼科完成角膜屈光手术的现役军事飞行人员病例,共10例,均为男性,年龄24～44(30.3±5.2)岁.统计和分析飞...     

Visual acuity, corrective lenses, and accidents in helicopter pilots

The visual acuity of 38 helicopter pilots experiencing serious air accidents was compared to that of a control group of 72 pilots, matched for age, aircraft, and hours of flight. Decrease in visual acuity was divided into two groups: 1) minor decreases in vision up to 20/25 (not requiring corrective lenses); and 2) visual acuity of 20/30 or less with correction to 20/20. Minor decreases in visual acuity were found in 23.7% (9/38) of those in the accident group compared to 25.0% (18/72) in the control group. There were more pilots in the control group who needed corrective lenses (12.5% (18/72) versus 2.8% (1/38), p less than 0.07). We conclude that helicopter pilots with corrective lenses or minor uncorrected decreases in visual acuity are not at increased risk for serious air accidents.     

仪表飞行时直升机飞行员脑力负荷的主观评价

目的 脑力工作超负荷可影响人的工作绩效并威胁飞行安全;大部分飞行事故发生在脑力工作负荷强度大的起飞、仪表或手动进近和着陆阶段,而且多是由人为差错引起.因此,为提高飞行作业绩效,维护飞行安全,测量和评定飞行员空中脑力工作负荷具有越来越重要的现实意义.本研究的目的是观察直升机飞行员仪表飞行时的脑力负荷变化.方法 采用修改的美国国家航空航天局任务负荷指数(NASA-TLX)评价量表,对15名直升机飞行员仪表飞行时不同阶段的脑力负荷进行了主观评价;对总脑力负荷评价值和飞行小时数进行了线性回归分析.结果 在起飞爬升阶段、巡航平飞阶段、下滑着陆阶段飞行员的总脑力负荷值分别为34.46±17.25、32.11±13.11和53.95±17.76.下滑着陆阶段飞行员的总脑力负荷值显著高于起飞爬升阶段和巡航平飞阶段的总脑力负荷值(F=25.767,P＜0.01).3个阶段的总脑力负荷的评价值均与飞行小时数呈显著负相关.在起飞爬升阶段,总脑力负荷的评价值与飞行小时数的线性回归方程为:总脑力负荷评价值=42.20-0.012 03×飞行小时数(r=-0.810,P＜0.01);在巡航平飞阶段,线性回归方程为:总脑力负荷评价值=38-51-0.006 04×飞行小时数(r=-0.535,P＜0.05).在下滑着陆阶段,线性回归方程为:总脑力负荷评价值=62.57-0.008 14×飞行小时数(r=-0.532,P＜0.05).结论 军用直升机飞行员仪表飞行时总脑力负荷的评价值与飞行小时数呈显著负相关,在下滑着陆阶段脑力负荷最大.     

The performance of standard vertical S-1 flight maneuvers by student U.S. Naval helicopter pilots

BACKGROUND: During flight training, student U.S. Naval helicopter pilots learn the use of flight instruments through a prescribed series of simulator training events. We recorded the training flights of 76 student U.S. Naval helicopter pilots undergoing the simulator phase of basic flight instrument training. From the final basic instrument simulator flight, the Vertical S-I (VS) flight maneuver, a standard flight maneuver required of the students, was selected for analysis. This maneuver was chosen because the ideal performance was well described. METHODS: The training simulator is the 2B42 training device, a 6 degrees of freedom, motion-based, high-fidelity instrument trainer. The quality of the flight performance of the cohort of student aviators executing the VS was described using objective measures of deviation from the ideal flight path. The measures included air speed, altitude, and heading average error from target values and standard deviations. RESULTS: The distributions of these scores for the 76 student pilots were described and used to calculate a composite score that summarized a student's overall performance of the maneuver. The worst four, the best four, and a group of four average pilots were identified from their composite scores and their relative performance was compared. CONCLUSIONS: A graphical summary of each pilot's flight performance was developed, and from this performance summary a pattern became evident that suggested that differences in performance levels were related to the use of flight instruments.     

Lytic spondylolisthesis in helicopter pilots

Trauma to the back from the force of chronic stress is thought to be an etiologic factor in isthmic spondylolisthesis (SLL). The relationship of first degree spondylolisthesis to low back pain (LBP) is controversial. We compare the prevalence of SLL in helicopter pilots who are subject to strong vibrational forces, with other airforce personnel. Helicopter pilots had more than a four times higher prevalence of SLL (4.5%) than did cadets (1.0%) and transport pilots (0.9%). Low back pain was more frequent in pilots with SLL than in those without this lesion but in no case was the pain disabling or the defect progressive. We conclude that SLL may be induced by vibrational forces and although SLL is associated with LBP, the pain was little clinical significance.     

Visual neglect: occurrence and patterns in pilots in a simulated overnight flight

INTRODUCTION: Visual neglect is the unconscious inability to recognize or acknowledge some visual information in the presence of a structurally intact visual system, and was hypothesized to occur with less than 24 h of continuous wakefulness. Visual perception was evaluated in military pilots during a simulated overnight flight to explore for the possible occurrence of visual neglect. METHODS: There were eight military pilots (male, 31-52 yr of age, mean 37 yr) on flight status who were recruited to perform the primary task of flying a simulated 12.5 h overnight mission after a day of continuous wakefulness and the secondary task of responding to repeated 20 min presentations of single- and double-light stimuli displayed in random sequence at 15 degrees intervals across the cockpit instrument panel. In addition to the visual performance task, simulator shutdowns occurring when the tolerances of the simulator were exceeded were measured and simple reaction time on the psychomotor vigilance task was assessed. Total continuous wakefulness was 26.5 h. RESULTS: Combined performance on the visual perception task showed response omissions increasing at 19 h of continuous wakefulness. Patterns included omissions at all stimulus locations, of primarily peripherally located stimuli, and of one of two simultaneously presented stimuli. Simulator shutdowns began at 21.5 h of continuous wakefulness. Correlation of visual task response omissions with simulator shutdowns was r = 0.95, p < 0.0001. CONCLUSIONS: Significant neglect of visual stimuli occurred in pilots beginning at 19 h of continuous wakefulness in a simulated overnight fixed wing aircraft flight, preceded simulator shutdowns, and correlated at 0.95 with simulator shutdowns.     

Back ache in helicopter pilots]

Due to low back pain (LBP) and harmful effects of flying, questionnaires were sent to 71 helicopter pilots of the experimental group, 22 mechanics helicopter flyers and to the control group of 28 air-traffic controllers. The prevalence of LBP was the highest in helicopter pilots, then in helicomechanics and air-traffic controllers (53%, 50% and 36%). Effects of exposure to vibration, body posture and working load have not contributed significantly to the occurrence of LBP. LBP has not lead to an important difference in the strength of the back musculature, body mass index and spondylosis, that is, scoliosis. The necessity of further study of LBP and maintaining of specific preventive measures are indicated.     

Back muscle EMG of helicopter pilots in flight: effects of fatigue, vibration, and posture

INTRODUCTION: The high prevalence of low back pain in helicopter pilots has been attributed to back muscle fatigue due to a pilot's required posture and/or aircraft vibration. This study investigated the effect of posture and vibration on the surface electromyogram (EMG) of right and left erector spinae (ES) muscles of pilots and evaluated ES fatigue during flight. METHODS: There were 12 male pilots who were monitored during helicopter flights lasting an average of 2 h. Prior to the flight, a maximal voluntary contraction (MVC) of ES was performed and the EMG was recorded. Vibration was measured at the pilot's seat through a triaxial accelerometer. The effect of posture on EMG was tested by comparing four characteristics of left and right EMG expressed as % MVC. Effect of Z vibration on EMG was investigated by coherence function and through correlation between coherently averaged EMG and Z for the frequencies of the main rotor of the helicopter (1R) and its first harmonic (2R). Fatigue was investigated through median frequencies (MF) of the EMG power spectra. RESULTS: No effect of posture on EMG was found for any parameter (p > 0.05). Data from one pilot suggested an effect of 1R on EMG, but statistical tests revealed this not to be significant (p > 0.05) for any pilot. No fatigue was evidenced by linear regression of MF. CONCLUSION: While the scientific literature contains the hypothesis that low back pain in helicopter pilots is mainly due to muscle fatigue caused by posture and/or vibration, the present study did not lend support to this hypothesis.     

飞行员飞行前后眼压的测定

采用美制非接触性眼压计，对132名健康歼击机飞行员的眼压进行了测定。结果显示，眼压均值为1．63±0．5kPa，眼压正常（0．9-2．4kPa）258眼，占97．7％。飞行前及飞行后5min眼压无显著性变化。发现单纯性青光眼1例，患病率0．76％。     

飞行员腹部大中手术后恢复飞行标准的探讨

目的 探讨飞行员腹部大中手术后恢复飞行的标准。方法 回顾分析腹部大中手术后恢复飞行的5例飞行员各项恢复飞行的标准，就相关问题进行讨论。讨论 要强调的是：①手术前就必须考虑到飞行员恢复后的飞行生涯;②恢复飞行的标准是对个人健康、飞行安全或完成任务没有危险；③恢复飞行前应进行适当的适应性训练，恢复飞行后定期随访。     

莫达非尼对军事飞行学员飞行工作能力和情感状态的影响

目的 观察莫达非尼对军事飞行学员飞行工作能力和情感状态的影响. 方法 21名男性飞行学员分两组：安慰剂组（n=10）和莫达非尼组（n=11）.在飞行前2 h（10：30）分别服用莫达非尼或安慰剂200 mg.对飞行活动中的心电进行连续监测,完成飞行任务后由飞行教员对飞行操作能力进行评价.此外,比较两组飞行前后的基本生命体征、视反应时、临界闪光融合频率和主观嗜睡感、疲劳感以及情绪情感状态的变化. 结果 与安慰剂相比,服用莫达非尼对飞行操作、生命体征、视反应时、临界闪光融合频率等指标均无明显影响,但使飞行中心率明显增加（平均增加15.7%,P＜0.01）、飞行后RPE量表的疲劳感积分明显降低（平均降低10%,P＜0.05）、POMS量表的“有力好动”感积分明显升高（平均升高20%,P＜0.05）. 结论 服用常规单剂量莫达非尼（200 mg）对飞行工作能力无明显不良影响,并有明显提高机体应激反应能力、降低主观疲劳感的作用.     

飞行员血小板的电子显微镜分型正常值及飞行后变化

用电子显微镜方法，将血小板（PC）分为圆、树突、过渡、展平和崩解五个型。对405例飞行员和550例地面工作人员，分别进行分型计数调查。发现36岁以上飞行员中树突型百分比明显高于同年龄地面人员，随着年龄增长，树突型和展平型均呈上升趋势，其余无差别；65岁以上树突型、展平和崩解型明显高于50岁以下者；飞行前后相比，飞行后PC各型均有不同程度改变。     

直升机飞行员飞行疲劳状况及相关因素分析

目的 了解直升机飞行员飞行疲劳状况,分析疲劳相关因素,为航空卫生保障工作提供参考依据.方法 采用疲劳量表14(FS-14)和匹兹堡睡眠质量指数(PSQI)问卷,测定90名直升机飞行员的疲劳指数和睡眠质量.与同期歼击机飞行员的比较,并根据直升机机型和飞行时间分组进行统计学分析.结果 直升机飞行员的疲劳指数略高于歼击机飞行员,差异无统计学意义(P>0.05).直升机飞行员的睡眠指数高于常模(P<0.001).飞行时间>1000 h的直升机飞行员的疲劳指数高于飞行时间≤1000 h飞行员.武装型直升机飞行员的疲劳指数高于运输型直升机飞行员.躯体疲劳、脑力疲劳及疲劳总分与睡眠指数的相关系数(r=0.586,P<0.001;r=0.461,P<0.001;r=0.617,P<0.001)有统计学意义.结论 直升机飞行员的飞行疲劳与睡眠指数正相关,应关注不同类型直升机飞行员的飞行疲劳状况.     

The performance of the standard rate turn (SRT) by student naval helicopter pilots

BACKGROUND: During flight training, student naval helicopter pilots learn the use of flight instruments through a prescribed series of simulator training events. The training simulator is a 6-degrees-of-freedom, motion-based, high-fidelity instrument trainer. From the final basic instrument simulator flights of student pilots, we selected for evaluation and analysis their performance of the Standard Rate Turn (SRT), a routine flight maneuver. METHODS: The performance of the SRT was scored with air speed, altitude and heading average error from target values and standard deviations. These average errors and standard deviations were used in a Multiple Analysis of Variance (MANOVA) to evaluate the effects of three independent variables: 1) direction of turn (left vs. right), 2) degree of turn (180 vs. 360 degrees); and 3) segment of turn (roll-in, first 30 s, last 30 s, and roll-out of turn). RESULTS: Only the main effects of the three independent variables were significant; there were no significant interactions. This result greatly reduces the number of different conditions that should be scored separately for the evaluation of SRT performance. The results also showed that the magnitude of the heading and altitude errors at the beginning of the SRT correlated with the magnitude of the heading and altitude errors throughout the turn. This result suggests that for the turn to be well executed, it is important for it to begin with little error in these two response parameters. CONCLUSIONS: The observations reported here should be considered when establishing SRT performance norms and comparing student scores. Furthermore, it seems easier for pilots to maintain good performance than to correct poor performance.