飞行人员空晕病的诊治和医学鉴定

目的 总结飞行人员空晕病的临床特征、诊治方法、防治措施及医学鉴定原则. 方法 回顾性分析1976年9月-2009年7月间住我院的49例飞行人员空晕病患者的病历资料,包括患者病史、病因与诱因、诊断分类、检查及医学鉴定结论 .对前庭功能检查结果与医学鉴定结论之间的关系进行统计学分析. 结果 ①本组病例原发性空晕病3例,继发性空晕病46例;继发性空晕病有其原发病因或诱因,其治疗主要为病因治疗和前庭功能脱敏习服训练;②前庭眼震电图检查正常者22例,异常者27例;③科里奥利加速度耐力正常者16例,不良者33例;④飞行合格11例,暂时飞行不合格10例,飞行不合格28例.前庭眼震电图异常者和科里奥利加速度耐力不良者飞行不合格率分别高于前庭眼震电图正常者和科里奥利加速度耐力正常者(χ2=5.584、16.722,P<0.05).结论 现役飞行人员空晕病多为继发性,防治措施包括治疗原发病因、消除诱因和加强前庭功能脱敏习服训练.其医学鉴定要兼顾原发病治疗效果、前庭功能状况及飞行机种情况.Abstract：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.

Diagnosis,treatment and medical evaluation of the flying personnel with airsickness

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.