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航空医疗救援人员沉浸式模拟训练生理应激反应及关联因素分析

Physiological stress responses and associated factors in immersive simulation training for aeromedical rescue personnel

    摘要
  • 摘要:
    背景 传统航空训练缺乏生理应激模拟，航空医疗救援人员面临的生理挑战未引起重视。
    目的 使用虚拟现实、增强现实等技术搭建沉浸式模拟训练系统，分析航空医疗救援人员使用该系统进行训练的生理应激反应及其关联因素。
    方法 采用航空医学救援沉浸式模拟训练系统对医疗救援人员进行30 min训练，收集训练前后的皮肤温度、心率、血压等应激相关生理指标，比较前后变化；以训练后唾液皮质醇(salivary cortisol，SC)为代表应激的主要指标，分析其关联因素。
    结果 121例参训人员中，男性83例(68.6%)，女性38例(31.4%)，中位年龄35(IQR：30 ~ 36)岁；训练前后的皮肤温度M(IQR)：30.2(29.5 ~ 31.2)℃ vs 32.1(31.5 ~ 32.6)℃、心率M(IQR)：71(68 ~ 78)次/min vs 80(74 ~ 85)次/min、收缩压M(IQR)：113(110 ~ 116) mmHg vs 123(120 ~ 126) mmHg、舒张压M(IQR)：78(73 ~ 81) mmHg vs 84(79 ~ 87) mmHg、平均压M(IQR)：90(86 ~ 93) mmHg vs 97(94 ~ 100) mmHg、皮肤电阻M(IQR)：470(335 ~ 600) kΩ vs 260(180 ~ 385) kΩ及SC(9.42±2.10) nmol/L vs (14.48±3.98) nmol/L差异均有统计学意义(P＜0.05)。不同性别、年龄、体质量指数、独生子女情况、婚姻状况、晕动病史、救援特情、体位的训练后SC差异有统计学意义(P＜0.05)。多元线性回归分析结果显示，性别、年龄、体质量指数、晕动病史、救援特情、训练体位与航空医疗救援人员沉浸式训练后SC水平独立关联(F＝34.748，P＜0.001)，可解释总变异的69.2%。
    结论 该沉浸式模拟训练系统具有较好的仿真效果，航空医疗救援人员进行沉浸式模拟训练后产生生理应激反应，其受多种因素的影响，应采取相应的干预与管理措施，提升航空生理训练效果。

     

    Abstract:
    Background Traditional aviation training lacks physiological stress simulation, the physiological challenges faced by aeromedical rescue personnel have not been adequately addressed.
    Objective To explore the physiological stress responses of aeromedical rescue personnel using an immersive simulation training system based on VR, AR technologies and analyze the associated factors.
    Methods An immersive simulation training system for aeromedical rescue was used to conduct a 30-minute training session for 121 medical rescue personnel. Physiological indicators such as skin temperature, heart rate, and blood pressure were collected before and after training, the changes were compared. SC levels after training were used as the dependent variable to analyze the associated factors.
    Results Among the 121 participants, there were 83 (68.6%) males and 38 (31.4%) females with a median age of 35 (IQR: 30 - 36) years old. The differences in skin temperature M(IQR): 30.2 (29.5-31.2) ℃ vs 32.1 (31.5-32.6) ℃, heart rate M(IQR): 71 (68-78) bpm vs 80 (74-85) bpm, systolic blood pressure 113 (110-116) mmHg vs 123 (120-126) mmHg, diastolic blood pressure 78 (73-81) mmHg vs 84 (79-87) mmHg, mean arterial pressure 90 (86-93) mmHg vs 97 (94-100) mmHg, ESR 470 (335-600) kΩ vs 260 (180-385) kΩ and SC (9.42±2.10 nmol/L vs 14.48±3.98 nmol/L) before and after the training for aeromedical rescue personnel were statistically significant (all P < 0.05). Post-training SC levels showed statistically significant differences across gender, age, BMI, only-child status, marital status, history of motion sickness, rescue scenarios and training posture (P < 0.05). Multiple linear regression analysis revealed that gender, age, BMI, history of motion sickness, rescue scenarios and training posture were the associated factors for SC levels after immersive training (F＝34.748, P < 0.001), which explained 69.2% of the total variation.
    Conclusion The immersive simulation training system demonstrates high fidelity. Aeromedical rescue personnel exhibit physiological stress responses after immersive training, which are influenced by multiple factors. Corresponding intervention and management measures should be implemented to enhance the effectiveness of aeromedical physiological training.

     

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