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中华航空航天医学杂志
中华航空航天医学杂志

卢志平

季刊

1007-6239

hkbjb@sina.com

010-66927182

100142

北京市阜成路28号

中华航空航天医学杂志/Journal Chinese Journal of Aerospace MedicineCSCDCSTPCD
查看更多>>1990年创刊，中华医学会主办。本刊以中文发表论文，国内外公开发行。主要读者对象为从事航空航天医学专业的高、中级专业人员和航空航天人机工程人员。栏目设置有论著、临床论著、综述、航医实践、病例报告、述评、专题论述、国际学术交流、人物述林、学术讲座、读者来信和消息报道等。刊文内容涉: 航空医学、航天医学、航空航天生理学、航空航天神经生理学和(或)视觉科学、各种加速度影响及其防护、航空航天人机工程、航空航天操纵技能与心理生理学、航空医疗运输等。
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    基于夜间进场着陆任务的飞行员眼动特征比较研究

    廖扬姚钦林榕戈含笑...
    1-6页
    查看更多>>摘要：目的 观测飞行员在经历黑洞错觉时的注意加工特点，了解飞行成绩高分飞行员的眼动模式，为开展眼动注视点引导的飞行模拟训练提供量化数据参考。 方法 采用整群抽样法选取参与改装训练的飞行员作为受试者，将原始飞行成绩转换成百分等级，以飞行成绩的前10名为高分组，后10名为低分组，记录其在飞行错觉模拟器上完成夜间进场着陆任务时的眼动数据，分析模拟任务中眼动数据和飞行成绩的关系，并比较不同飞行成绩飞行员的眼动模式差异。 结果 选取有效受试者36人。共计12个眼动指标与飞行成绩相关（r=0.334~0.398，P均<0.05），其中平显地平信息区的扫视脱离速度、平显速度信息区的注视总时长占任务总时长的百分比、地平仪完全注视的平均时间3个眼动指标可与飞行成绩建立线性回归模型（R2=0.422，F=7.77，P<0.001）。高分组飞行员对平显中的速度显示信息的完全注视总时长占任务总时长的百分比［（4.38±3.48）%］高于低分组［（1.72±1.32）%］，差异有统计学意义（t=2.25，P=0.045）；高分组飞行员从平显地平信息区的扫视平均脱离速度［（358.85±171.40）°/s］高于低分组［（221.14±92.60）°/s］，差异有统计学意义（t=2.24，P=0.038）。 结论 夜间进场着陆任务中的眼动指标可作为飞行员在黑洞错觉模拟体验任务中的注意能力评估指标。 Objective To observe the attention processing characteristics of the pilots experiencing black hole illusion, and to provide quantitative data references for flight simulation training guided by eye movement fixation based on the eye movement mode of the pilots with high flight performance score. Methods The pilots who underwent the transformation training were selected by cluster sampling. Their original flight performance scores were converted into percentile grades. The top 10 and bottom 10 pilots were assigned as high and low score groups. Their eye movement data were recorded when they were completing the night approach and landing task on the flight illusion simulator. The correlation between eye movement data and flight performance in the simulation task were analyzed, and the eye movement patterns of pilots with different flight performance were compared. Results Thirty-six valid subjects were selected. A total of 12 eye movement indexes were correlated with flight performance (r=0.334-0.398, all P<0.05). Three eye movement indexes, including peak velocity of exit saccade from attitude indicator of head-up display (HUD), the percentage of total duration of fixations on airspeed indicator of HUD to the total task duration and average duration of whole fixations on attitude indicator could establish a linear regression model with flight performance (R2=0.422, F=7.77, P<0.001). The percentage of total duration of whole fixations on airspeed indicator of HUD to the total task duration in high score group [(4.38±3.48)%] was higher than that in low score group [(1.72±1.32)%], and the difference was statistically significant (t=2.25, P=0.045). And the average peak velocity of exit saccade from attitude indicator of HUD in high score group [(358.85±171.40)°/s] was higher than that in low score group [(221.14±92.60)°/s], and the difference was statistically significant (t=2.24, P=0.038). Conclusions Eye movement index in the night approach and landing task can be used as an evaluation index of attention ability of pilots in black hole illusion simulation and experience task.

    错觉注意力眼动夜间进场着陆飞行员

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    飞行学员基础+G z耐力测试与相关因素分析

    卫晓阳李宝辉徐艳蒋科...
    7-12页
    查看更多>>摘要：目的 测试飞行学员的基础+Gz耐力，并对影响其抗荷能力的相关因素进行调查分析，为提升飞行学员抗荷能力与改进训练方法提供依据。 方法 采用整群抽样法，选取57名健康男性飞行学员进行抗荷能力测试，测试指标包括离心机基础+Gz耐力、双下肢最大蹬力、最大呼气压力（maximal expiratory pressure，MEP）及最大吸气压力（maximum inspiratory pressure，MIP）。根据基础+Gz耐力高低分组；基础+Gz耐力较低组内按耐力终点视觉有无变化进行分组。按双下肢最大蹬力的水平高低分组。采用问卷调查方式了解离心机测试情况及飞行学员平时体能训练情况，根据问卷结果，按有氧训练强度分为低训练组（≤3次/周）与高训练组（>3次/周）。 结果 飞行学员的离心机基础+Gz耐力测试结果为3.5 G和4.0 G 2个水平，平均为（3.56±0.17）G；双下肢最大蹬力平均为（449.3±105.6）kgf（1 kgf=9.806 N），MEP平均为（20.1±3.5）kPa，MIP平均为（10.5±2.3）kPa。基础+Gz耐力4.0 G组的MEP高于3.5 G组，差异有统计学意义（t=2.08，P=0.043）。基础+Gz耐力3.5 G的飞行学员中，视觉无变化组的MEP高于视觉变化组，差异有统计学意义（t=2.35，P=0.023）。高蹬力组（≥449.3 kgf）的基础+Gz耐力高于低蹬力组（<449.3 kgf），差异有统计学意义（t=2.20，P=0.035）。66.7%的学员以前未学过正确的抗荷动作；91.2%的学员进行长跑训练；82.5%的学员进行力量训练；57.9%的学员进行下肢力量训练，但其中45.6%的人不清楚每个肌群力量的正确训练方法。有氧训练的高训练组MEP高于低训练组，差异有统计学意义（t=3.25，P=0.002）；高训练组双下肢最大蹬力低于低训练组，差异有统计学意义（t=2.35，P=0.022）。 结论 飞行学员的抗荷能力在离心机上表现不佳，应该尽可能提早安排初次飞行前的离心机体验与训练，同时加强以力量训练为主的抗荷体能训练。 Objective To provide references for promoting the anti-G ability of flying cadets and improving the training methods by testing the flying cadets′ relaxed +Gz tolerance and analyzing the related factors. Methods Fifty-seven healthy male flying cadets were tested for anti-G ability by cluster sampling. The indicators included relaxed +Gz tolerance, maximal pedal force of lower limbs, maximal expiratory pressure (MEP) and maximum inspiratory pressure (MIP). The subjects were divided into high and low tolerance groups, and the low tolerance group was divide into 2 groups by judging if they were with or without visual change. The subjects were divided into high and low limbs strength groups by measured maximal pedal force. The questionnaire was used to get the information of human centrifuge test and the physical training of flying cadets at ordinary time. According to the results of the questionnaires, the subjects were divided into low strength (≤3 times/week) and high strength (>3 times/week) physical training groups by aerobic training intensity. Results Relaxed +Gz tolerance test results of the flying cadets were 3.5 G and 4.0 G, with an average of (3.56±0.17) G. Maximal pedal force of lower limbs was averagely (449.3±105.6) kgf (1 kgf=9.806 N). MEP was averagely (20.1±3.5) kPa. MIP was averagely (10.5±2.3) kPa. MEP of 4.0 G group was higher than that of 3.5 G group, and the difference was significant (t=2.08, P=0.043). In the subjects of 3.5 G relaxed +Gz tolerance, MEP of unchanged vision group was higher than that of changed vision group, and the difference was significant (t=2.35, P=0.023). Relaxed +Gz tolerance of high pedal force group (≥449.3 kgf) was higher than that of low pedal force group (<449.3 kgf), and the difference was significant (t=2.20, P=0.035). 66.7% of the subjects did not learn correct anti-G maneuver 91.2% of the subjects took long-distance running 82.5% of the subjects took strength training 57.9% of the subjects did lower limbs strength training, but 45.6% of them did not understand the correct methods of training muscle groups. MEP of the high training group was higher than that of low training group, and the difference was significant (t=3.25, P=0.002). Maximal pedal force of lower limbs in the high training group was lower than that in the low training group, and the difference was significant (t=2.35, P=0.022). Conclusions The flying cadets′ anti-G ability is not good in centrifuge. They should be arranged to experience and trained in human centrifuge as early as possible. Anti-G physical training should be enhanced based on anaerobic exercise.

    加速度超重力身体耐力问卷调查体能训练飞行学员

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    飞行员运动心肺功能评价指标研究

    黄炜杨少颖季一鑫徐建华...
    13-18页
    查看更多>>摘要：目的 比较分析不同机种飞行员运动心肺功能的差异，以及不同心肺功能指标间的相关性。 方法 本研究为回顾性研究。选取68名航空医学鉴定均为飞行合格的空军飞行员，使用意大利科时迈运动心肺功能测试仪，按照25 W/min功率递增速率进行运动心肺功能测试。将研究对象按照飞行机种分为歼击机组和其他机种组，比较两组飞行员运动心肺功能差异；分析最大摄氧量与年龄、BMI的相关性，以及心率恢复与运动耐量的相关性。 结果 歼击机组飞行员（32人）与其他机种组飞行员（36人）的最大心率、呼吸商、运动结束后1 min心率恢复值差异有统计学意义（t=2.28、2.50、2.37，P=0.026、0.049、0.021），其他指标差异无统计学意义。最大摄氧量与年龄、BMI呈负相关（r=-0.329、-0.339，P均<0.001）。运动结束后2、3 min心率恢复值均与最大摄氧量、最大运动功率呈正相关（r=0.284、0.290、0.306、0.268，P=0.001、0.026、0.002、0.002）。 结论 运动心肺功能指标在不同机种飞行员间差异有统计学意义，随年龄及体重增加相关指标存在显著变化。运动后心率可监测不同训练状态下心肺功能变化。 Objective To compare and analyze the differences of exercise cardiopulmonary function and the correlation of different cardiopulmonary function indexes among different aircraft types in pilots. Methods Retrospective study was used. The exercise cardiopulmonary function of 68 Air Force pilots who were qualified for flight in aeromedical identification were tested with the Italian Cosmed exercise cardiopulmonary function tester at a power increasing rate of 25 W/min. The subjects were divided into fighter group and other aircraft group according to aircraft types. The differences of exercise cardiopulmonary function between 2 groups were compared. The correlation between maximal oxygen uptake and age, body mass index, and the correlation between heart rate recovery and exercise endurance were analyzed. Results There were significant differences in maximal heart rate, respiratory quotient and heart rate recovery value at 1 min after exercise between fighter group (32 cases) and other aircraft group (36 cases) (t=2.28, 2.50, 2.37, P=0.026, 0.049, 0.021). There was no significant difference in other indexes. The maximal oxygen uptake was negatively correlated with age and body mass index (r=-0.329, -0.339, both P<0.001). The values of heart rate recovery at 2 min and 3 min after exercise were positively correlated with maximal oxygen uptake and maximal exercise power (r=0.284, 0.290, 0.306, 0.268, P=0.001, 0.026, 0.002, 0.002). Conclusions The indexes of exercise cardiopulmonary function have significant differences among pilots in different aircraft types, and there are significant changes with age and weight gain. The heart rate after exercise can monitor the changes of cardiopulmonary function under different training conditions.

    加速度心率运动抗荷耐力最大摄氧量飞行员

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    单中心军事飞行人员低剂量肺部CT检查结果分析

    陈珊珊陆勤燕徐建华王雷...
    19-24页
    查看更多>>摘要：目的 分析军事飞行人员低剂量肺部CT检查结果，并探讨其对航空医学鉴定的影响。 方法 回顾性分析于空军杭州特勤疗养中心行年度体检的军事飞行人员影像学及航空医学鉴定资料。将纳入的低剂量肺部CT检查结果按影像学表现分为未见明显异常、陈旧性病灶、肺结节、肺大疱、肺部炎性病变及肺外附见疾病6类。统计分析各类检查结果的检出率，并按年龄分为20~29岁、30~39岁、40~49岁、50~59岁组，按职别分为歼教机飞行员、轰运直飞行员、轰运直机组成员组，比较不同年龄组及职别组飞行人员检查结果的差异。按照不影响航空医学鉴定结论、导致健康等级下降、导致暂时飞行不合格3种程度，分析检查结果对航空医学鉴定的影响。总体显著性水平α=0.05，两两比较以P<α/统计次数为差异有统计学意义。 结果 共纳入2 274名飞行人员。各类检查结果按检出率从高到低依次为未见明显异常（45.82%）、陈旧性病灶（37.55%）、肺结节（14.86%）、肺大疱（6.73%）、肺部炎性病变（2.59%）及肺外附见疾病（1.85%）。不同年龄组的检查结果差异有统计学意义（χ2=183.43，P<0.001）。20~29岁和30~39岁组未见明显异常检出率最高；40~49岁和50~59岁组陈旧病灶检出率最高。未见明显异常检出率随年龄增大而递减，陈旧性病灶检出率随年龄增大而递增（P均<α/6=0.008）；40~49岁组肺结节检出率高于30~39岁组；50~59岁组肺大疱检出率高于其他年龄组；40~49岁和50~59岁组肺部炎性病变检出率高于其他年龄组；50~59岁组肺外附见疾病高于20~29岁组，差异均有统计学意义（P均<0.008）。不同职别飞行人员检查结果差异有统计学意义（χ2=33.78，P=0.001）。轰运直机组成员未见明显异常的检出率低于轰运直及歼教机飞行员组，而陈旧性病灶和肺结节的检出率高于其他组，差异均有统计学意义（P均<α/3=0.017）；歼教机飞行员组肺大疱检出率低于轰运直机组成员，差异有统计学意义（P<0.017）。虽然检出结果中绝大多数对航空医学鉴定结果无影响，但不同检出疾病导致健康等级下降及暂时飞行不合格比例差异有统计学意义（Fisher精确检验值=82.81，P<0.001）。 结论 低剂量肺部CT检查在军事飞行人员健康体检及航空医学鉴定中发挥了重要作用，可作为飞行人员年度体检必查项目。肺部相关疾病的航空医学鉴定标准与策略也应同步更新匹配。 Objective To analyze the results of low-dose lung CT screening for military flying personnel, and to explore its influence on aeromedical identification. Methods The imaging and aeromedical identification data of military flying personnel who underwent annual physical examination in Air Force Healthcare Center for Special Services Hangzhou were analyzed retrospectively. According to the imaging manifestations, the enrolled low-dose lung CT results were divided into the following 6 categories: no obvious abnormality, old lesions, pulmonary nodules, pulmonary bullae, pulmonary inflammatory lesions and extrapulmonary diseases. The detection rates of various examination results were statistically analyzed. The military flying personnel were divided into 20-29 years group, 30-39 years group, 40-49 years group and 50-59 years group, and they were divided into fighter pilots, bomb-trans-helicopter pilots, and bomb-trans-helicopter crew members according to the post. The differences in various examination results of flying personnel were compared among different age groups and post groups. The influence of examination results on the aeromedical identification results was analyzed in accordance with the 3-level conclusions as not affecting the conclusion of aeromedical identification, leading to the decline of health grade and leading to temporary grounding. The overall significance level α=0.05, and the pairwise comparison with P<α/statistical times was statistically significant. Results A total of 2 274 flying personnel was enrolled. The detection rates of various examination results from high to low was no obvious abnormality (45.82%), old lesions (37.55%), pulmonary nodules (14.86%), pulmonary bullae (6.73%), pulmonary inflammatory lesions (2.59%) and extrapulmonary diseases (1.85%). There was significant difference among examination results of different age groups (χ2=183.43, P<0.001). The detection rate of no obvious abnormality was the highest in 20-29 years group and 30-39 years group the detection rate of old lesions was the highest in 40-49 years group and 50-59 years group. The detection rate of no obvious abnormality decreased with age, and the detection rate of old lesions increased with age (bothP<α/6=0.008). The detection rate of pulmonary nodules in 40-49 years group was higher than that in 30-39 years group the detection rate of pulmonary bullae in 50-59 years group was higher than that in the other age groups the detection rates of pulmonary inflammatory lesions in 40-49 years group and 50-59 years groups were higher than those in the other age groups the detection rate of extrapulmonary diseases in 50-59 years group was higher than that in 20-29 years group, and the differences were statistically significant (all P<0.008). There was significant difference in the results of flying personnel among different post groups (χ2=33.78, P=0.001). The detection rate of no obvious abnormality in bomb-trans-helicopter crew members group was lower than that in bomb-trans-helicopter pilots group and fighter-trainer pilots group, but the detection rates of old lesions and pulmonary nodules were higher than those in the other groups, the differences were statistically significant (all P<α/3=0.017). The detection rate of pulmonary bullae in fighter-trainer pilots group was lower than that in bomb-trans-helicopter crew members group, and the difference was statistically significant (P<0.017). Although majority of the detected results had no effect on the results of aeromedical identification, there was a significant difference in the proportion of health grade decline and temporary grounding caused by different detected diseases (Fisher exact test value was 82.81,P<0.001). Conclusions Low-dose lung CT screening plays an important role in the physical examination and aeromedical identification for military flying personnel. It can be routinely used during the annual physical examination for flying personnel, and the aeromedical identification standards and strategies for lung related diseases should be updated synchronously.

    肺疾病体层摄影术,X线计算机体格检查合格鉴定飞行人员

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    886名军事飞行人员航空性牙痛发病情况的调查分析

    周游岳志鹏阮源李园园...
    25-28页
    查看更多>>摘要：目的 分析军事飞行人员航空性牙痛的发病情况，为提出相应的预防和治疗策略提供依据。 方法 采用整群抽样法，对在联勤保障部队大连康复疗养中心参加疗养的886名男性飞行人员进行航空性牙痛的问卷调查及口腔科体检，比较不同机种、不同飞行状态下飞行人员航空性牙痛发生情况。 结果 72名飞行人员发生过航空性牙痛，总发生率为8.13%。不同机种飞行人员航空性牙痛的发生率差异有统计学意义（χ2=15.65，P<0.001）。飞行人员航空性牙痛的发生次数随着飞行高度的增加而增加（χ2=38.94，P<0.001）。不同飞行速度下飞行人员航空性牙痛的发生次数差异有统计学意义（χ2=9.60，P=0.008）。不同飞行姿态时飞行人员航空性牙痛的发生次数差异有统计学意义（χ2=16.02，P<0.001）。有口腔疾病的飞行人员时飞行人员航空性牙痛的发生率高于未检出口腔疾病的飞行人员，差异有统计学意义（χ2=43.23，P<0.001）。 结论 患有口腔疾病的军事飞行人员更易发生航空性牙痛，应有针对性地制定预防和治疗方案，从而保障飞行安全。 Objective To provide references for putting forward prevention and treatment strategies by analyzing the incidence of aerodontalgia in military flying personnel. Methods Using cluster sampling, 886 male flying personnel who recuperated in Dalian Rehabilitation Center of PLA Joint Support Force were investigated by questionnaire and oral examination. The incidence of aerodontalgia in flying personnel were compared among different aircraft types and flight status. Results A total of 72 flying personnel had aerodontalgia, and the total incidence of aerodontalgia was 8.13%. There was significant difference in the incidence of aerodontalgia among the flying personnel of different aircraft types (χ2=15.65, P<0.001). The frequency of aerodontalgia of the flying personnel increased with the increase of flight altitude (χ2=38.94, P<0.001). The frequency of aerodontalgia of the flying personnel among different flight speeds was significant (χ2=9.60,P=0.008). The frequency of aerodontalgia of the flying personnel among different flight status was significant (χ2=16.02,P<0.001). The incidence of aerodontalgia in flying personnel with oral diseases was higher than those without oral diseases, and the difference was significant (χ2=43.43, P<0.001). Conclusions Military flying personnel with oral diseases are easily attacked by aerodontalgia. Prevention and treatment programs should be formulated to ensure flight safety.

    航空牙痛问卷调查军事飞行人员

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    力量训练联合物理疗法治疗飞行员非特异性腰痛的疗效分析

    张嘉涛赵晨煜卫芬董劲霞...
    29-33页
    查看更多>>摘要：目的 探讨力量训练联合物理疗法治疗飞行员非特异性腰痛的疗效。 方法 采用非随机平行对照研究。采取问卷调查方式从航空兵部队选取具有轻、中度非特异性腰痛表现的飞行员，根据自愿原则进行分组。综合治疗组进行时长为3个月的治疗，包括力量训练和物理疗法；对照组不参与本次康复方案，按照日常情况进行生活与工作，不限制力量训练与物理治疗，分别比较治疗前后2组飞行员的目测类比法（Visual Analogue Scale，VAS）疼痛评分、McGill疼痛问卷（McGill Pain Questionnaire，MPQ）评分及腰背部肌肉力量。 结果 共纳入飞行员109人，其中自愿加入综合治疗组21人，对照组88人。治疗前2组飞行员的VAS疼痛评分、MPQ评分差异均无统计学意义（P均>0.05）；治疗后综合治疗组VAS疼痛评分、MPQ评分均低于对照组，差异有统计学意义（t=1.98、2.31，P=0.048、0.021）。治疗前2组飞行员腰背部肌肉力量差异无统计学意义（P>0.05）；治疗后综合治疗组飞行员腰背左侧屈、右侧屈和后伸最大力量增加值高于对照组，差异有统计学意义（U=2.17、2.47、3.64，P=0.002、0.013、<0.001）。 结论 力量训练联合物理疗法可有效缓解飞行员非特异性腰痛，提升了其腰部肌肉力量，可在飞行员非特异性腰痛防治工作中推广应用。 Objective To investigate the efficacy of strength training with physical therapy in the treatment of nonspecific low back pain in pilots. Methods A non-randomized, parallel controlled study was used. The pilots with mild and moderate nonspecific low back pain were selected from the aviation unit by questionnaire survey. They were grouped on a voluntary basis. In the comprehensive treatment group, pilots were treated for 3 months, including strength training and physical therapy. In the control group, pilots who did not participate in the rehabilitation program, lived and worked according to daily conditions, and they were not restricted by strength training and physical therapy. The Visual Analogue Scale (VAS) pain scores, McGill Pain Questionnaire (MPQ) scores and low back muscle strength were compared between the 2 groups of pilots before and after treatment. Results A total of 109 pilots were selected, among which 21 pilots volunteered to join the comprehensive treatment group and 88 pilots in the control group. Before treatment, there was no significant difference in VAS pain scores and MPQ scores between the 2 groups of pilots (both P>0.05). After treatment, the VAS pain scores and MPQ scores of the comprehensive treatment group were lower than those in the control group, and the difference was significant (t=1.98, 2.31, P=0.048, 0.021). Before treatment, there was no significant difference in low back muscle strength between the 2 groups of pilots (P>0.05). After treatment, the increments in maximum strength of left flexion, right flexion, and posterior extension of pilots in the comprehensive treatment group was higher than those in the control group, and the differences were statistically significant (U=2.17, 2.47, 3.64, P=0.002, 0.013,<0.001). Conclusions Strength training with physical therapy can effectively alleviate nonspecific low back pain in pilots and improve the strength of waist muscles. It can be promoted and applied in the prevention and treatment of nonspecific low back pain in pilots.

    腰痛物理治疗技术问卷调查力量训练飞行员

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    中国民航招飞屈光度预测模型研究

    王益蓉沈紫琼刘欢申芙蓉...
    34-38页
    查看更多>>摘要：目的 探讨民航招飞现行眼科标准中，散瞳前电脑验光屈光度预测散瞳后检影验光屈光度的准确性，评价现行招飞标准中“超出标准0.75 D及以上”为评定界限的合理性，并为调整招飞屈光度标准提供科学依据。 方法 采取整群抽样法选取2017年至2021年参加中国民航飞行学院四川地区招飞体检的学生，包括高中生及大学生改飞行驾驶的学生；收集其散瞳前电脑验光及散瞳后检影验光的屈光度值，以散瞳前电脑验光屈光度为自变量拟合回归模型，用于预测散瞳后检影验光的屈光度值。 结果 共纳入参加招飞体检学生2 567名，均为男性，平均年龄为（18.20±1.47）岁。散瞳前电脑验光屈光度与散瞳后检影验光屈光度存在高度相关（rs=0.856，P<0.001）。依据回归模型计算散瞳后检影验光屈光度预测区间，散瞳前电脑验光屈光度可解释散瞳后检影验光屈光度变异程度的80.5%。散瞳前电脑验光屈光度为［-7.000，+1.500］D时，该模型预测准确率≥83.3%，拟合效果较好。当散瞳前电脑验光屈光度高于-6.125 D时，95%预测区间值均高于-4.500 D，即超出招飞标准。 结论 对于近视学生，散瞳前电脑验光屈光度超出-6.125 D者，散瞳后检影验光屈光度预测值均超出现行招飞标准，建议将标准中对应条目修改为“超出标准1.750 D及以上者，可终止受检者进行其他检查”。 Objective To explore the accuracy of computer optometric diopter before mydriasis in predicting artificial optometric diopter after mydriasis in the current ophthalmic standard of civil aviation recruitment, to evaluate the rationality of "0.75 D or more beyond the standard" in the current recruitment standard, and to provide a scientific basis for adjusting the recruitment diopter standard. Methods Cluster sampling was used to select students recruited by Civil Aviation Flight University of China in Sichuan area from 2017 to 2021, including high school students and college student candidates. The values of computer optometric diopter before mydriasis and optometric diopter after mydriasis were collected, and the linear regression model was fitted to predict the optometric diopter value after mydriasis with computer optometric diopter before mydriasis as independent variable. Results A total of 2 567 recruited students, all male, with an average age of (18.20±1.47) years were enrolled in the physical examination. There was a high correlation between computer optometric diopter before mydriasis and optometric diopter after mydriasis (rS=0.856, P<0.001). After linear regression fitting and calculation of the predicted range of post-dilated optometric diopter, it was found that pre-dilated computer optometric diopter could explain 80.5% of the variation degree of post-dilated optometric diopter. When the computer optometric diopter before mydriasis was in the range of [-7.000,+1.500] D, the prediction accuracy of this model was ≥83.3%, and the fitting effect was good. When the computer optometric diopter before mydriasis was higher than -6.125 D, the prediction interval of 95% was higher than -4.500 D, which was beyond the recruitment standard. Conclusions For myopic students, the predicted value of post-dilated optometric diopter exceeds the current recruitment standard if the computer optometric diopter before mydriasis exceeds -6.125 D. It is suggested to amend the corresponding item in the standard to "if the diopter exceeds 1.750 D or more, the subject can be terminated other examinations".

    屈光,眼视觉预测模型,统计学招飞学生

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    军事飞行员前庭功能稳定性训练前后效果观察

    费祥武郭建生蔡达王军...
    39-42页
    查看更多>>摘要：目的 对军事飞行员前庭功能稳定性进行评价，为军事飞行员前庭功能稳定性训练提供依据。 方法 应用电动转椅对军事飞行员进行前庭功能稳定性训练。按照入院顺序，分别选取21~30岁、31~40岁、41~50岁、≥51岁年龄段各30名飞行员，比较不同年龄段飞行员训练前后前庭功能稳定性的优秀率、良好率、合格率、不合格率以及耐受时间变化，并分析年龄与耐受时间的相关性。 结果 31~40岁、≥51岁组飞行员训练前后不合格率比较差异有统计学意义（χ2=4.32、4.80，P=0.038、0.028）。飞行员前庭功能稳定性训练后不合格率较训练前降低，差异有统计学意义（χ2=13.02，P<0.001）。总耐受时间均较训练前增加，差异有统计学意义（t=17.61，P<0.001）。不同年龄组飞行员前庭功能训练后其稳定性耐受时间均较训练前增加，差异有统计学意义（t=6.50、8.82、9.48、13.56，P均<0.001）。随着年龄的增加，前庭功能稳定性逐步减退，年龄与训练耐受时间呈负相关（r=-0.38，P<0.001）。 结论 电动转椅训练可增强军事飞行员前庭功能稳定性，增加耐受时间，提高前庭功能受到刺激时的耐受能力。 Objective To provide references for the vestibular function stability training of military pilots by evaluating the stability of vestibular function of military pilots. Methods An electric swivel chair was used to train the vestibular function stability of military pilots. According to the order of admission, they were divided into 21-30 years old, 31-40 years old, 41-50 years old and ≥51 years old group, with 30 pilots in each group. The changes of excellent rate, good rate, qualified rate, unqualified rate and tolerance time of the stability of vestibular function by training were compared among different age groups, and the correlation between age and tolerance time was analyzed. Results There were significant differences of unqualified rate in pilots aged 31-40 and ≥51 years group before and after training (χ2=4.32, 4.80, Ρ=0.038, 0.028). The failure rate after training was lower than that before training, with a significant difference (χ2=13.02, P<0.001). The total tolerance time was higher than that before training, and the difference was statistically significant (t=17.61, P<0.001). The stability tolerance time of pilots in different age groups after vestibular function training were increased compared with that before training, and the differences were statistically significant (t=6.50, 8.82, 9.48, 13.56, all P<0.001). The stability of vestibular function of military pilots gradually declined with the increase of age, and there was a negative correlation between age and training tolerance time (r=-0.38, P<0.001). Conclusions The training of electric swivel chair can improve the vestibular function stability of military pilots, increase the tolerance time, and enhance the tolerance ability of military pilots when vestibular function is stimulated.

    前庭功能习服耐受时间军事飞行员

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    歼击机飞行员双侧肩袖损伤1例并文献复习

    王震刘婧源张建业王涛...
    42-45页
    查看更多>>摘要：目的 通过分析1例歼击机飞行员肩袖损伤的发病机制、临床诊治及航空医学鉴定，为今后该病的防治提出建议。 方法 回顾性分析1例歼击机飞行员双侧肩袖损伤的诊断、治疗、预后及航空医学鉴定，并复习相关文献。 结果 该病例既往右侧肩袖损伤经保守治疗后航空医学鉴定为飞行合格，正常参加飞行。患者此次左侧肩袖损伤，经保守治疗后，左侧关节活动正常，无功能障碍，疼痛缓解后航空医学鉴定结论为飞行合格。 结论 航空军医要提高对肩袖损伤的认识，了解其发病原因、机制及治疗方法，熟悉相关的辅助检查和保守治疗手段，掌握相关体格检查方法，以便做好防治工作。 Objective To analyze the pathogenesis, clinical diagnosis, treatment and aeromedical identification of rotator cuff injury in a fighter pilot, and to put forward prevention and treatment suggestions. Methods The diagnosis, treatment, prognosis and aeromedical identification of bilateral rotator cuff injury in a fighter pilot were retrospectively analyzed, and the relevant literatures were reviewed. Results After conservative treatment of the right rotator cuff injury in the past, the pilot was qualified for flight and participated in normal flight. After conservative treatment of the left rotator cuff injury, the left joint activity was normal without dysfunction. After pain relief, the pilot was qualified for flight. Conclusions In order to do a good job in prevention and treatment, flight surgeons should improve the understanding of rotator cuff injury, understand its etiologies, pathogenesis and therapies, be familiar with relevant auxiliary examinations and conservative treatments, and master the necessary physical examinations.

    肩关节创伤和损伤合格鉴定飞行员

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    直升机领航员创伤后应激障碍1例并文献复习

    郭庆军张斌许涛佟宇...
    45-48页
    查看更多>>摘要：目的 分析军事飞行人员创伤后应激障碍的临床特征和诊断治疗。 方法 报道1例创伤后应激障碍直升机领航员的临床治疗过程，并复习相关文献。 结果 本例直升机领航员发病的直接诱因是单位发生一等飞行事故；以反复的创伤性体验、情绪低落、兴趣减退、持续的警觉性增高，如入睡困难、做噩梦等为主要临床表现，符合创伤后应激障碍诊断标准。经药物治疗，配合心理治疗，达到临床治愈。地面观察结束后，航空医学鉴定结论：飞行合格。 结论 应重视军事飞行人员心理筛查，提高对创伤后应激障碍的诊断意识，药物配合心理治疗是治愈此类疾病较好的方案。 Objective To analyze the clinical characteristics, diagnosis and treatment of post-traumatic stress disorder (PTSD) in military flying personnel. Methods The clinical treatment process of a helicopter navigator with PTSD were reported and the related literatures were reviewed. Results The direct inducement of this case was that the helicopter navigator experienced the influence of a first-class flight accident. The main clinical manifestations of this case were repeated traumatic experience, low mood, decreased interest and continuously increased alertness, such as difficulty in falling asleep and nightmares, which met the diagnostic criteria for PTSD. After drugs with psychological treatment, the patient was clinically cured. After the observation on ground, the patient was qualified for flight. Conclusions Emphasis should be placed on psychological screening to improve the diagnostic awareness of PTSD in military flying personnel. Drugs with psychological treatment may be a good method to cure such diseases.

    应激障碍,创伤后合格鉴定帕罗西汀直升机领航员

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