晕动病4例分析及对航空医学选拔鉴定的启示

Motion sickness in military aircrews and candidates: Case series and implication for aeromedical selection and assessment

  • 摘要:
      目的   通过对有代表性的晕动病案例进行分析,提出涉及晕动病的航空医学选拔及鉴定的建议。
      方法   分析2019年6月在空军特色医学中心诊断为晕动病的4例病例资料,并复习国内外相关文献,结合空晕病航空医学鉴定实际经验,做出医学鉴定结论,提出建议。
      结果   病例1:招飞体检应征者,在定选阶段行科里奥利加速度耐力检查呈Ⅱ°反应,前庭自旋转试验提示前庭功能异常,既往12岁之前有晕车史,现乘车仍出现晕车症状,其父亲有晕车史,诊断为原发性空晕病。病例2:招飞体检应征者,在定选阶段行科里奥利加速度耐力检查呈Ⅱ°反应,既往16岁出现晕车,现症状更为明显,诊断为继发性空晕病。病例3:拟改空中乘员,进行起落飞行体验时出现明显晕机症状,既往12岁前有晕车史,现乘车乘机仍有症状,其父亲、奶奶及妹妹均有晕车史,科里奥利加速度耐力检查Ⅱ°反应,冷热试验因出现呕吐未完成,前庭自旋转试验示水平增益低于正常值,感觉整合试验示总分低于正常值,诊断为原发性空晕病。病例4:空中乘员,因飞行中多次出现头晕、恶心入院治疗,既往12岁前有晕车史,现无减轻,父母及姐姐均有晕车史,诊断为原发性空晕病。
      结论   在飞行学员医学选拔和地改空医学选拔中,要把晕动病作为一个专项病史进行询问,采用现代前庭功能检测技术进行精确评价并相互印证,同时应参考航空医学最新研究成果指导晕动病的鉴定工作。

     

    Abstract:
      Objective  To analyze cases with motion sickness in military aircrews and candidates, and put forward suggestions for aeromedical selection and assessment.
      Methods   Clinical data about 4 motion sickness aircrews/candidates admitted to the air force specialized medical center in June 2019 were analyzed. We reviewed relevant literatures and drew the conclusion of aeromedical assessment based on practical experience.
      Results   Among the 2 candidates for the medical examination of the pilot recruitment, one case of primary motion sickness was diagnosed due to levelⅡ° response to the Coriolis effect. Vestibular autorotation test indicated that the vestibular function was abnormal. He had a history of car sickness before the age of 12, and till now he still had car sickness symptoms while riding. His father also had a history of car sickness. One candidate of secondary motion sickness was diagnosed due to levelⅡ° response to the Coriolis effect. Car sickness symptoms started at the age of 16, and now the symptoms were more obvious. Among the two air stewards, one case of primary airsickness was diagnosed due to obvious airsickness symptoms appeared during flight training of taking-off and landing. She had a history of car sickness before the age of 12, and now motion sickness symptoms still existed when taking bus or plane. Her father, grandmother and sister also had a history of car sickness. She had level Ⅱ° response to the Coriolis effect, and did not complete Caloric test because of vomiting. The vestibular autorotation test and sensory organization test indicated that the vestibular function was abnormal. One steward with primary airsickness was diagnosed due to dizziness and nausea for many times during the flight. She had a history of car sickness before the age of 12, till now the symptoms of car sickness did not relieve. Her parents and sister also had a history of car sickness.
      Conclusion   Motion sickness should be regarded as an independent question when taking medical history. Modern detection technology should be used for accurate vestibular function assessment, and latest aeromedicine research should be referred to guide the assessment of motion sickness.

     

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