飞行人员眩晕的随访及分析

Vertigo in military aircrew: Causes, classification and medical assessment

  • 摘要:
      目的   对住院飞行人员眩晕疾病诊疗情况、飞行结论及预后进行随访及分析,为眩晕疾病航空医学鉴定提供参考。
      方法   对2006年1月- 2018年12月以眩晕为主诉在空军第986医院空勤科住院治疗的26例飞行人员进行随访,对眩晕发作类型、病因、诊治及航空医学鉴定情况进行分析。
      结果   26例均为男性,发病年龄21 ~ 56(35.81±8.63)岁。依据前庭疾病国际分类(international classification of vestibular disorders,ICVD)及《眩晕诊治多学科专家共识》确定慢性前庭综合征11例,发作性前庭综合征6例,急性前庭综合征3例,非前庭系统疾病6例。引起眩晕的主要病因分类:前庭外周性眩晕6例,前庭中枢性眩晕6例,精神心理性头晕8例,全身疾病相关性头晕6例。本组经治疗及地面观察,13例予飞行合格结论,医学停飞1例(飞行学员);转空军特色医学中心进一步诊治12例,其中治疗康复后飞行合格8例,医学停飞4例。
      结论   持续性姿势知觉性头晕、良性阵发性位置性眩晕是导致飞行人员眩晕的主要病因。慢性前庭综合征是导致飞行人员医学停飞的主要原因。依据ICVD及《眩晕诊治多学科专家共识》对眩晕发作类型及病因进行分类,有助于诊治流程的优化及飞行结论的预判。

     

    Abstract:
      Objective  To analyze the causes of vertigo symptom and its medical evaluation in military aircrew by follow-up so as to provide evidences for aeromedical assessment.
      Methods   Clinical data about 26 aircrews with vertigo symptoms admitted to PLA No. 986 Hospital of Air Force from January 2006 to December 2018 were collected, and the clinical characteristics, diagnosis and treatment, medical evaluation and outcomes were followed up and analyzed.
      Results   All the 26 cases were male, and the age of onset ranged from 21 to 56 years (average age of 35.81±8.63 years). According to the international classification of vestibular disorders (ICVD), the 26 cases were divided into three classes of vestibular syndromes, which included 11 cases of chronic vestibular syndromes, 6 cases of episodic vestibular syndromes, and 3 cases of acute vestibular syndromes. And there were 6 cases of non-vestibular system disorders, which included 3 cases of cervicogenic dizziness and 3 cases of systemic diseases related vertigo. Etiological factors of vertigo symptom were categorized to vestibular peripheral vertigo (6 cases), vestibular central vertigo (6 cases), psychogenic dizziness (8 cases) and systemic diseases related vertigo (6 cases). Of the 26 cases, 21 cases were qualified for flying after treatment and ground observation, 5 cases were permanent grounded due to psychological reasons and long-term abnormal vestibular function.
      Conclusion   Persistent postural-perceptual dizziness and benign paroxysmal positional vertigo are the main types of vertigo in military aircrew, and chronic vestibular syndrome is the main reason of the medical permanent grounded, which suggests that more attention should be paid to psychological intervention and vestibular rehabilitation in treatment of vertigo.

     

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