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。     

273例突发性耳聋疗效分析

突发性耳聋（sudden hearing loss,SHL）即突然发生的原因不明的感音神经性聋,其病因不明,发病机制复杂。主要表现为听力在瞬间、几小时或几天内突然下降,耳聋或轻或重,重者全聋,多为单侧。青年及中老年均可发病,在飞行人员中也时有报道。该病治疗疗效不十分理想,有一定自限性,临床上常予以扩血管、     

大型复合低压舱检测飞行人员耳气压功能价值研究

目的：探讨大型复合低压舱模拟缺氧及大气压力降低时的飞行环境,在检测飞行人员耳气压功能中的应用价值。方法：选择某部直升机飞行人员158例,首先询问病史,并进行电耳镜、纯音测听、声导抗及前鼻镜和鼻内镜检查,无低压舱耳气压功能检查禁忌证者再进入舱内进行测试。以15m／s的速度“上升”至4000m,停留5min后以5m／s的速度“下降”至地面。每“上升”和“下降”1000m,飞行人员在症状列表中选钩一次主观感觉。出舱后复查电耳镜、纯音测听和声导抗。结果：除1例因近日感冒,未安排进舱而终止检查外,其余157例（314耳）均完成检查。其中,在不同高度分别出现耳闷胀、耳压痛等症状75例150耳,在3000~1000m下降时症状加重。出舱后电耳镜检查鼓膜Ⅱ度充血19例30耳、Ⅲ度充血1例1耳;纯音测听检查听力异常20例31耳,呈轻至中度传导性聋;声导抗测试c型曲线19例22耳,B型曲线3例3耳。耳气压功能完全正常139例281耳,基本正常8例16耳。达耳气压功能不良诊断标准10例17耳,其中,轻度6例12耳,中度1例1耳,重度3例4耳。结论：大型复合低压舱耳气压功能检查,在飞行人员航空性中耳炎诊断、疗效评估及做飞行结论中具有重要应用价值。     

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。     

高压氧综合治疗突发性聋60例

突发性聋是一种常见的突然发生的感音神经性耳聋。我院自1986年6月～1999年5月应用高压氧(HBO)配合药物治疗突发性聋患者60例,较常规药物治疗取得较好的效果,现报告如下。一、临床资料1.一般资料:HBO组60例(72耳),均为海洋石油作业男性职工,其中单耳发病48例,双耳12例;年龄19～62岁,平均43.4岁。听力以500,1000,2000Hz3个频率平均听力损失计算,结果为轻度聋(10～30dB)9耳,中度聋(31～60dB)28耳,重度聋(61～90dB)31耳,全聋(>90dB)4耳。对照组41例(45耳),均为海洋石油作业男性职工,单耳发病37例,双耳4例;年龄22～57岁,平均38.5岁。听力损…     

突发性耳聋患者不同类型听力曲线与临床疗效关系分析

目的 分析突发性耳聋患者不同类型听力曲线与临床疗效的关系.方法 回顾性分析本院收治的113例（118耳）突发性耳聋患者临床资料,按不同的初始听力曲线分为低频型23耳,中频型9耳,高频型28耳,平坦型41耳和全聋型17耳5组.均在接受高压氧治疗的同时给予1-3周的静脉用药治疗.结果 经治疗后患者各型听力曲线有效率分别为：低频型95.7%,中频型77.8%,高频型60.7%,平坦型78%和全聋型52.9%.结论 不同类型听力曲线突聋患者中,低频型疗效最好,其次为平坦型、中频型,全聋型疗效最差.     

飞行人员胆脂瘤型中耳炎的特点

目的 探讨飞行人员胆脂瘤型中耳炎的特点。方法 总结飞行人员胆脂瘤型中耳炎资料6例7耳,其中右耳5例,双耳1例。结果 4例4耳手术治疗后干耳,2例3耳观察;2例飞行暂不合格,4例飞行合格。结论 咽鼓管机能障碍是飞行人员胆脂瘤型中耳炎的主要病因。医学鉴定根据术后听力损失程度,咽鼓管机能状况和其他因素综合考虑。     

美尼尔氏病的低压舱治疗

Densert等提出了通过暴露于低气压环境下,即所谓低压治疗来降低美尼尔氏病患者内耳压力的设想,并发现,将美尼尔氏病患者置于低压舱内,他们的低频感音性听力减退、耳鸣、耳闷塞及眩晕等症状得到了即时改善。Tjerns trom等曾报告,经低压治疗的46例(47耳)美尼尔氏病患者中,有21耳获得了即时听力增益。 我们在Soesterberg国家航空航天医学中心对34例美尼尔氏病患者进行了低压舱治疗实验。受试患者符合下述标准:①单侧或双侧感觉神经性耳聋,并伴有耳鸣和原因不明的眩晕发作(史);②经ABLB试验、Bekesy氏听力计、镫骨反射试验及声响衰退试验检查,显示听觉     

飞行人员体检中耳聋的诊断

对飞行人员体检中耳聋的诊断,目前还没有统一的标准,体检中耳聋的诊断名称显得有些零乱,给体检统计工作带来很大不便,同时也不利于体检质量的监督与检查。笔认为飞行人员体检中耳聋的诊断应为：（1）构成临床耳聋诊断的,按临床耳聋疾病诊断;（2）对不构成临床耳聋诊断的,可诊断为轻度听力减退、中度听力减退和重度听力减退。以不断地提高体检质量,推进标准化水平进程,并使体检资料统计工作计算机化。     

特发性一侧前庭功能异常与航空航天飞行

目的　探讨特发性一侧性前庭功能异常与航空航天飞行的关系。　方法　分析30例飞行人员特发性一侧前庭功能异常的病例。　结果　右前庭功能减弱者19例，左前庭功能减弱者9例，左前庭功能丧失者2例；11例飞行合格，19例永久停飞。　结论　一侧前庭功能异常可因飞行错觉和/或运动病反应而危及飞行安全；航空航天飞行也能诱发或加重前庭功能损害。     

飞行人员咽鼓管机能障碍对内耳功能的影响

目的　探讨飞行人员咽鼓管机能障碍对内耳听功能和前庭功能的影响。　方法　总结飞行人员咽鼓管机能障碍和内耳功能异常的临床资料 2 6份。　结果　 2 6例中感音神经性耳聋者 18人 ,梅尼埃病者 3人 ,神经性耳鸣者 3人 ,突发性耳聋和前庭功能障碍者各 1人。　结论　咽鼓管机能障碍不仅可引起航空性中耳炎 ,而且可引起或加重内耳功能的损害。     

Medical-psychological aspects of flying training of pilots for informal aviation structure]

The authors report the data of medical and psychological monitorized of in formal aviation pilots trained for flying motor-hang-planes. Monitoring was conducted in two categories of pilots: professionals (reserves, n = 6) and amateurs (n = 6). Psychophysiological profile and level of neuroemotional stress before and after training were in correlation with previous flying experience. These results point to the importance of differential approach to planning and preparation of training flights for different categories of pilots.     

General aviation crashes involving military personnel as pilots.

BACKGROUND: Injuries sustained in off-duty activities are a major cause of mortality and morbidity among military personnel. Reducing these off-duty fatalities is a continuing priority of the military. METHODS: General aviation crashes recorded by the National Transportation Safety Board between 1983 and 1998 were analyzed for military pilots (n = 205) and other military personnel (n = 185), and compared with all other general aviation crashes (n = 32,807) to identify differences in the crash circumstances and sustained injury severities. RESULTS: During the 16-yr study period, a total of 45 military pilots and 52 other military personnel were fatally injured while flying general aviation flights. Military pilots who were involved in general aviation crashes were more likely to have advanced licenses and higher total flight times when compared with other military personnel and civilian pilots (p < 0.05). Among the three groups of pilots, other military personnel had the least flying time and the largest percentage of student/private licenses. Military personnel had significantly less time in type in the 90-d and 30-d periods preceding the crash compared with civilians (p < 0.05). Shoulder restraint usage was associated with less severe injuries for all groups. We estimate that general aviation deaths have cost the military at least $405 million since 1983. CONCLUSIONS: General aviation crashes are a costly source of mortality and morbidity for military personnel, particularly military pilots. Interventions aimed at improving safety of military personnel in the general aviation setting warrant special consideration.     

Hypoxia symptoms reported during helicopter operations below 10,000 ft: a retrospective survey

INTRODUCTION: During routine aviation medicine training, rotary-wing aircrew are instructed that the impact of hypoxia on them from flying in unpressurized cabins up to 10,000 ft (3048 m) above mean sea level (AMSL) is relatively small and has few implications for aviation safety. Such reassurance is based on data derived from experiments conducted on resting subjects and may not reflect the true impact of hypoxia in aircrew engaged in operational tasks. METHOD: A survey listing common symptoms of hypoxia was distributed to Australian Army helicopter aircrew who had operated at altitudes up to 10,000 ft AMSL. RESULTS: There were 53 surveys that were returned (71% response), representing 25 loadmasters, 23 pilots, and 5 aircrewman technicians. All respondents were Australian Army aircrew. One or more symptoms consistent with hypoxia were reported by 86.6% of non-pilot aircrew and 60.9% of pilots. 60% of non-pilot aircrew reported four or more symptoms, compared with only 17% of pilots. The most commonly reported symptoms were difficulty with calculations (45%), feeling light-headed (38%), delayed reaction time (38%), and mental confusion (36%). Loadmasters reported more symptoms (mean 5.4) than pilots (mean 2.2) (p < 0.001). From the narratives provided (n = 21), aircrew experienced potentially operationally significant symptoms at a mean altitude of 8462 ft (2579 m). CONCLUSION: The helicopter aircrew surveyed reported symptoms consistent with hypoxia at altitudes within the so-called physiological zone; loadmasters reported more effects than pilots. It may be inappropriate to emphasize the benign nature of the physiological zone during aviation medicine training of a non-resting population such as helicopter aircrew.     

军事飞行员原发性青光眼的医学鉴定分析

目的 探讨因原发性青光眼和可疑青光眼住院的军事飞行员的疾病特点、飞行结论 及放飞观察情况. 方法 对95例因青光眼或可疑青光眼住院的飞行员资料进行回顾性临床分析.结果 95例住院患者中56例诊断为原发性开角型青光眼(POAG),其中停飞15例,飞行暂不合格3例,飞行合格38例,放飞观察中延长飞行年限1～26年,平均6.36±1.43年.36例怀疑青光眼者进行青光眼排除检查,33例排除了青光眼,飞行合格;3例临床可疑,飞行暂不合格.3例诊断为高眼压症,飞行合格. 结论 飞行员最多见的青光眼类型是开角型青光眼;患POAG的飞行员若视功能稳定,在严密观察下能够继续飞行;早期发现和及时治疗是控制疾病的关键.     

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.