感觉神经性耳聋及其与航空航天飞行的关系

目的探讨感觉神经性耳聋与航空航天飞行的关系。方法地分析３６名飞行人员感觉神经性耳聋病例。结果３６例中单侧耳聋１５例,双侧耳聋２１例;轻度聋９耳,中度聋３７耳,重度聋１１耳;１９例永久停飞,１７例飞行合格。结论感觉神经性耳聋因影响空中通讯而危及飞行安全;航空航天飞行也能引起或加重感觉神经性耳聋。     

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。     

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.     

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。     

军事飞行人员颅内未破裂动脉瘤航空医学鉴定

目的 探讨军事飞行人员颅内未破裂动脉瘤（unruptured intracranial aneurysms, UIA）的航空医学鉴定原则。方法 回顾性分析2014年1月—2021年1月在空军特色医学中心就诊的疑似UIA的飞行人员9例,收集其临床诊疗、航空医学鉴定和随访情况,并复习国内外相关文献。结果 由旋转三维数字血管造影检查共确诊5例飞行人员,年龄23～44岁,其中三代机飞行员3例,二代机飞行员1例,直升机飞行员1例。患有颈内动脉海绵窦段动脉瘤者3例,颈内动脉眼动脉段动脉瘤者2例;4例动脉瘤直径≤3 mm,1例直径为>3 mm且<5 mm;医学观察4例,介入手术1例。1例患有颈内动脉眼动脉段动脉瘤者,飞行不合格;3例颈内动脉海绵窦段动脉瘤者,特许飞行合格（限双座）;1例颈内动脉眼动脉段动脉瘤者仍处于治疗观察期,暂时飞行不合格。结论 对于偶然发现的颈内动脉海绵窦段单发动脉瘤,直径≤3 mm、形态规则,其发生自发破裂致蛛网膜下腔出血的风险极低,可予特许飞行;对于最大径>3 mm且≤5 mm的颈内动脉海绵窦段动脉瘤,可考虑限轰运直、无人机飞行;其他情况的动脉瘤者建议飞行不...     

飞行学员航空性中耳炎1例

1　临床资料患者男性 ,2 3岁 ,教 8飞行学员 ,初教 6飞行 110h ,教 8飞行 80h。新年度训练开飞 ,飞行前体检正常。飞行中爬升时 ,有耳胀感 ,做咽鼓管通气动作后好转。返场时 ,因大速度下滑 ,有明显压耳感 ,再做咽鼓管通气动作未能成功 ,双耳疼痛 ,以右侧为主 ,听力下降。返场后主诉耳痛 ,听力下降。查体 :双鼓膜内陷 ,周围充血 ,右耳较重 ,鼓膜呈弥漫性充血 ,鼓膜周围的外耳道皮肤发红 ,左鼓膜的松弛部与沿锤骨柄的部位充血。诊断 :航空性中耳炎。结论 :飞行暂不合格。2　讨论航空性中耳炎又称气压损伤性中耳炎或耳气压损伤。本病是由于…     

海军飞行人员207例飞行暂不合格疾病谱分析

有关军事飞行人员飞行不合格疾病谱的研究,各国都非常重视.有关飞行暂不合格,空军和陆航都已有大量的报道.我院在海军飞行人员年度大体检中,经常发现部分飞行人员因某种疾病致飞行暂不合格.     

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。     

238例海军飞行人员因病飞行暂不合格的疾病分析

目的通过分析238例海军飞行人员飞行暂不合格的疾病情况，探索降低医学暂不合格率的有效措施，以减少海军飞行人员非战斗减员。方法 对238例飞行暂不合格按病因、年龄、机种、职务和时间分布进行分类。结果 内科疾病致飞行暂不合格居各科疾病之首(39．1％)，中青年飞行员飞行暂不合格率较高(89％)，驾驶员所占比例较大(39％)，飞行时间在1001—2000h之间者居多(50％)。结论 中青年飞行员飞行暂不合格率较高，尤其要加强对中青年飞行人员心血管疾病的健康教育和防治工作；各海军疗养院空勤科和航空兵部队航医室，要特别注重加强对驾驶员和飞行时间在1001-2000h之间飞行人员的行政管理和医疗保健，以最大限度降低飞行暂不合格率。     

Hypertension and orthostatic hypotension in applicants for flying training and aircrew

Although blood pressure standards in aircrew members have been revised periodically over the past 70 years, hypertension still remains one of the most controversial problems in aviation medicine. Improved clinical knowledge and operational experience vindicate a more liberal attitude for acceptable blood pressure levels. Applicants for flying training presenting labile hypertension may be accepted. Also, experienced, older aircrew with benign hypertension controlled by drugs without adverse reactions and without target organ disease may remain on flying status. In order to avoid compromising flight safety, long-term monitoring of flight crew for the diagnosis of hypertension together with the evaluation of anti-hypertensive drugs in aircrew is urgently required.     

民航飞行人员骨代谢指标的调查分析

目的了解高空飞行人员的骨代谢情况,分析飞行人员骨代谢水平与飞行时间的关系,探讨航空环境因素对飞行人员骨代谢的影响。方法随机选择某航空公司男性健康飞行人员134名,年龄20～60岁,37名当地男性健康地面人员作为对照组,年龄20～60岁。各组按照年龄分成3组:20～年龄组,30～年龄组,40岁及以上年龄组,分别采用放射免疫分析法测定血清骨钙素(BGP)水平,采用酶联免疫分析法测定血清骨特异性碱性磷酸酶(BALP),其结果用组间t检验进行比较,各变量与飞行时间之间进行相关分析。结果飞行人员BGP水平和BALP水平均低于对照组,飞行人员BGP水平和BALP水平与对照组比较,在20～年龄组和30～年龄组均显著降低(P<0.01),40～年龄组之间没有统计学差异(P>0.05),与累积飞行时间呈显著性负相关(P<0.01)。结论航空复杂的环境因素可影响飞行人员的骨代谢水平,并且与飞行时间相关。     

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.     

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.