高性能战斗机飞行员选拔体检结果分析

目的 了解当前歼击机飞行员身体状况,进一步搞好高性能战斗机飞行员航空卫生保障工作.方法 对55名歼击机飞行员进行全面的临床体检和离心机 Gz耐力检查,确定飞行结论,并对结果进行统计分析比较.结果 ①飞行合格者45人,占总人数的81.8%;飞行不合格者10人,占总人数的18.2%,其中加速度耐力不良7人,外科疾病2人,耳鼻喉科疾病1人.②心电图异常、脂肪肝及脊柱疾患的检出率较高.有21.8%的飞行员加速度耐力低下.结论 要进一步加强飞行员各级体检工作,在招飞体检中加强脊柱疾患的检查,杜绝患有活动性疾病飞行员在队飞行,重点防治心血管疾病.要制定高 Gz抗荷训练方案,以提高歼击机飞行员 Gz耐力.     

高性能战斗机飞行员医学选拔若干问题探讨

目的 探讨高性能战斗机飞行员医学选拔中存在的问题，为选拔合格的高性能战斗机飞行员提供依据和指导。方法 采用询问病史、全面体检和综合评价的方法，对214例低机种歼击机飞行员体检发现的问题进行评价。结果 在参选低机种歼击机飞行员中，高性能战斗机改装合格192例，改装不合格并原机种合格，19例，原机种不合格3例。结论 飞行员基本身体状况、基础飞行耐力和加速度耐力是高性能战斗机飞行员的选拔评价重点。     

1260例飞行人员住院疾病谱分析

目的 分析近10年住院飞行人员疾病谱特点.为提高新时期特勤医疗保障水平提供依据. 方法采集2001 2010年1 260例住院飞行人员的资料信息,对其年龄分布、疾病种类、飞行机型、飞行时间等进行统计分析.对比高性能战斗机飞行员及普通歼击机飞行员的疾病谱特点.结果 飞行人员肌肉骨骼系统疾病、消化系统疾病、神经系统疾病成为位居前3的住院疾病种类;高性能战斗机飞行员常见疾病种类为肌肉骨骼系统疾病、神经系统疾病、泌尿生殖系统疾病,主要疾病是泌尿系结石、关节软组织损伤、神经衰弱、腰椎间盘突出症、偏头痛、航空性疾病及代谢异常;与普通歼击机飞行员相比,高性能战斗机飞行员泌尿系结石、神经衰弱的疾病比例显著增加(x2 =26.28、5.23,P＜0.05或0.01),腰椎间盘突出症、航空性疾病的住院年龄显著增大,偏头痛的住院年龄明显减小、飞行时间明显减少. 结论 现代军事飞行人员的疾病谱发生变化,高性能战斗机飞行员常见疾病与飞行特点、生活方式密切相关,应全方位给予干预指导.     

580例歼击机飞行员的基础+Gz耐力检查结果分析

目的 分析歼击机飞行员的基础+Gz耐力检查结果. 方法 对580例歼击机飞行员的基础+Gz耐力分布、平均+Gz耐力、检查合格率,以及检查结果与年龄、飞行时间的关系进行了分析.基础+Gz耐力的检查在六三型载人离心机上进行,采用SPSS 10.0软件对试验数据进行统计学分析. 结果 该组飞行员的平均基础+Gz耐力为4.26±0.43 G,离心机检查合格率为81.4%.27～31岁年龄组飞行员的合格人数最多,共184人;37～43岁年龄组飞行员的合格率最高,达90.5%.平均+Gz耐力、检查合格率与年龄及飞行时间具有相关性(P＜0.05). 结论 以+4.25 Gz持续10s(+Gz增长率1 G/s)作为基础+Gz耐力合格标准是合理的.通过增加监测飞行员用力情况的措施,可进一步完善检查方法.     

高性能战斗机改装体检原机种飞行合格者的随访观察

目的 从不同层面总结航卫保障和高性能战斗机改装体检经验. 方法 对高性能战斗机改装体检时结论为原机种飞行合格的127名飞行员进行随访,获取其健康状况和飞行结论资料,做出综合分析. 结果 ①改装体检原机种飞行合格原因中,特殊功能检查不达标及外、内科病症是主要原因,与同时段改装体检原机种暂时飞行不合格主因相似、程度不同.②其中32人再次入院改装体检,26例改装体检飞行合格,6例维持原机种合格.改装合格的26人中,17人原离心机检查不达标,后达标改装合格;余9例分别患各种病症,治疗及观察后明显好转改装合格,均飞行状况佳,完成和超额完成年度飞行任务.原机种合格的6例中,5人因离心机检查末达标,再次改装体检其中4人仍未达标.1人达标但因腰椎间盘突出症仍原机种合格;l例患白细胞减少症,2年半后白细胞仍低,再次结论为原机种飞行合格.③95例末进行第2次改装体检,其中9例停飞,余仍原机种飞行合格.停飞9人中,4例因新患疾病,3例因改装体检发现的病症,2例因技术或其他原因而停飞. 结论 高性能战斗机改装体检时所做的原机种飞行合格的结论是恰当的,《高性能歼击机飞行员体格检查要求》是符合实际的,但应重视社会-心理因素、特殊功能检查和脊柱问题对改装体检合格率的影响.应重视飞行人员年度大体检,及时发现健康隐患,保证飞行安全.     

歼击机飞行员飞行不合格的疾病谱分析

目的分析歼击机飞行员飞行不合格疾病谱,为新时期航卫保障提供参考依据.方法对空军总医院收集的飞行不合格的300名歼击机飞行员病例资料按疾病类别、涉及专科及不同年龄段进行分类计数.结果①歼击机飞行员飞行不合格的常见疾病为空中晕厥、加速度耐力不良、地面晕厥、航空性中耳炎、飞行错觉、眩晕、颈椎病、屈光不正、神经衰弱和血管性头痛等.②与歼击机飞行员飞行不合格最相关的专科有神经科、耳鼻咽喉科和骨科等.③飞行不合格的飞行员多集中在25～34岁间.结论与航空环境相关的一些疾病是空军总医院收集的歼击机飞行员飞行不合格的重要原因,今后应有针对性地加强歼击机飞行员的日常训练,同时重视社会-心理因素对飞行员的影响.     

高性能歼击机飞行员改装时的航空卫生工作重点

高性能歼击机飞行员改装时的的航空卫生工作重点分为3个阶段:一是飞行员体检阶段;二是飞行员理论学习阶段;三是飞行员飞行改装阶段。只要航空卫生工作者或卫勤领导把握住每个阶段的工作要点,就能比较顺利地完成改装的航空卫生保障工作。     

高性能歼击机飞行员体质指数与＋Gz耐力分析

随着空军发展步伐的加快,高性能战斗机逐步装备部队,对高性能战斗机飞行员的身体素质提出了更高的要求.如何更好地适应现代高性能战斗机的持续高载荷、高载荷增长率、高角加速度[1-2]等特点,充分发挥飞行员自身的潜能,更加熟练地驾驭战斗机,体质在其中起到了非常关键的作用.我院空勤科通过对310名不同年龄段经高性能战斗机改装体检合格后的飞行员身高、体重进行测量,计算出体质指数（kg/m2）,同时收集飞行员的飞行时间,在离心机上进行测试,从而得出＋Gz耐力与身高、体重、体质指数及飞行时间的关系,为高性能战斗机改装体检提供了客观依据;为飞行员的合理膳食及有效地进行专项体能训练起到了很好的指导作用,现报道如下.     

现代军事飞行学员医学选拔的特点与医学鉴定（摘要）

目的探讨军事飞行学员医学选拔的体检方法,使选拔的飞行学员适合现代高性能战斗机飞行。方法通过对高性能战斗机飞行特点分析和近年来对多批次招收军事飞行学员的经验,总结选拔军事飞行学员的方法、程序及其特点。结果军事飞行学员医学选拔的方法以高性能战斗机飞行特点为切入点,强调脊柱检查、可能影响飞行耐力的潜在疾患、     

高性能战斗机飞行员左下肺叶腺癌切除术后放飞一例并文献复习

目的 本文旨在复习飞行员肺癌相关文献,并探讨高性能战斗机飞行员肺癌肺叶切除后的航空医学鉴定思路和标准. 方法结合1例高性能战斗机飞行员左下肺腺癌的临床诊断、手术治疗、康复情况及健康鉴定和康复后的飞行情况,复习相关文献,对高性能战斗机飞行员肺癌肺叶切除后的医学鉴定进行探讨. 结果该飞行员有左下肺孤立性结节病史10年,无主诉及临床症状,经肺CT检查提示结节影较前变大并伴毛刺状,正电子发射断层摄影检查呈异常放射性浓聚灶,临床诊断为肺癌.行左下肺叶切除术及淋巴结清扫术,术后病理结果为高分化腺癌,未进行放疗、化疗.飞行暂不合格,地面观察1年,经临床检查未见肿瘤复发及转移,心、肺功能检查大致正常,加速度耐力检查合格,飞行结论为合格.恢复飞行12个月,飞行时间65 h,来院复查未见异常. 结论肺癌肺叶切除的高性能战斗机飞行员,术后无复发、转移,心肺功能及加速度耐力良好者,可飞行合格.     

480例歼击机飞行员体检资料分析

目的 分析歼击机飞行员体检资料，发现问题、提出对策。方法 统计1999年至今在我中心为改装高性能机种进行健康体检的480例歼击机飞行员病历资料，综合分析，得出结论。结果 检出50余种疾病及病症。患高脂血症及脂肪肝者占29.7％；经X线、CT、MRI检出颈、腰椎有异常表现者占23.1％；加速度耐力不良者占8.9％。结论 歼击机飞行员应注意预防高脂血症、颈、腰椎病等，提高加速度耐力，加强心理训练。     

Patterns of physical conditioning in Royal Australian Air Force F/A-18 pilots and the implications for +Gz tolerance.

BACKGROUND: The role of physical conditioning in tolerance to +Gz remains the subject of debate, particularly in relation to the relative merits of aerobic vs. anaerobic conditioning. The purpose of this study was to document the patterns of physical conditioning in Royal Australian Air Force (RAAF) fighter pilots and to relate these findings to the question of +Gz tolerance. METHODS: A questionnaire was used to determine the physical conditioning activities of RAAF F/A-18 pilots. Aerobic fitness levels (VO2max) were determined in a sample of eight pilots using a progressive cycle ergometer protocol. RESULTS: Of the 42 F/A-18 pilots who completed the questionnaire, 86% reported regular physical conditioning, mostly three times per week. Aerobic activities were the most common (83%), with running the most popular activity (55%). Anaerobic activities were reported by 26% of respondents. Most respondents reported doing more than one activity, with an average weekly training volume of 129+/-77 min. The ergometer test results revealed a mean VO2max of 50+/-6 ml O2 x kg x min(-1). CONCLUSION: The high rates of participation in regular physical activity suggest that physical fitness is perceived as important by the fighter pilot operating in the high +Gz environment. The fighter pilots in this study participated in aerobic activities at a much higher rate than anaerobic activities. The aerobic fitness levels measured suggest that the pilots have good but not exceptionally high levels of aerobic power that are unlikely to influence +Gz tolerance.     

Thoracolumbar pain among fighter pilots.

High +Gz forces place high stress on the spinal column, and fighter pilots flying high-performance fighter aircraft frequently] report work-related thoracic and lumbar spine pain. The aim of this study was to determine whether +Gz exposure causes work-related thoracolumbar spine pain among fighter pilots. A questionnaire was used to establish the occurrence of thoracic and lumbar spine pain during the preceding 12 months and during duties over the whole working career among 320 fighter pilots and 283 nonflying controls matched for age and sex. Thirty-two percent of the pilots and 19% of the controls had experienced pain in the thoracic spine during the preceding 12 months (odds ratio [OR] = 2.3; 95% confidence interval [CI] = 1.5-3.5; p = 0.002 for the pilots). Among the pilots, the OR increased up to 6.1 (95% CI = 1.6-23.1; p = 0.0007) with the number of +Gz flight hours. There was no difference between the groups with regard to lumbar pain during the preceding 12 months, but over their whole working careers fighter pilots (58%) had experienced lumbar pain during their duties more often than controls (48%) (OR = 1.8; 95% CI = 1.3-2.6; p = 0.002). The greater the number of +Gz flight hours, the greater the occurrence of lumbar spine pain when on duty (OR = 26.9; 95% CI = 6.2-116; p = 0.0001 for the most experienced fighter pilots). The same was not true with regard to the number of +Gz flight hours and lumbar pain during the preceding 12 months. Age had no effect on pain in the thoracic or lumbar spine. Fighter pilots flying high-performance aircraft have more work-related thoracic and lumbar spine pain than controls of the same age and sex. The difference is explained by the pilots' exposure to +Gz forces.     

+Gz associated stenosis of the cervical spinal canal in fighter pilots

Previous magnetic resonance imaging (MRI) studies have shown that repeated exposure to +Gz forces can cause premature degenerative changes of the cervical spine (i.e. a work-related disease). This paper reports on two clinical cases of +Gz-associated degenerative cervical spinal stenosis caused by dorsal osteophytes in fighter pilots. Conventional x-rays and MRI were used to demonstrate narrowing of the cervical spinal canal. The first case was complicated by a C6-7 intervertebral disk prolapse and a congenitally narrow spinal canal. The second case involved progressive degenerative spinal stenosis in the C5-6 disk space which required surgery. The findings in this case were confirmed by surgery which showed posterior osteophytes and thickened ligaments compressing the cervical medulla. These two cases suggest that +Gz forces can cause degenerative spinal stenosis of the cervical spine. Flight safety may be jeopardized if symptoms and signs of medullar compression occur during high +Gz stress. It is recommended that student fighter pilots undergo conventional x-rays and MRI studies in order to screen out and reject candidates with a congenitally narrow spinal canal. These examination methods might be useful in fighter pilots' periodic medical check-ups in order to reveal acquired degenerative spinal stenosis.     

中等水平+Gz暴露对飞行员尿微量白蛋白、尿α1微球蛋白及尿常规检测指标的影响

目的 观察中等水平+Gz暴露对飞行员尿微量白蛋白(MA)、尿α1微球蛋白(α1M)及尿常规10项检测指标的影响.方法 33名歼击机飞行员接受离心机基础+Gz耐力检查,最高加速度暴露水平为+4.25 G/10 s,观察10名飞行员+Gz暴露后2 h和23名飞行员+Gz暴露后24 h尿液指标中MA、α1M和尿常规10项指标的变化情况.结果 离心机检查前,33名飞行员尿液指标检测结果均正常.离心机检查完毕所有飞行员均无明显不适主诉.离心机检查后2 h有1名飞行员尿MA高于正常值,1名飞行员尿α1M高于正常值,次日复查正常,尿常规10项检测结果均正常,但+Gz暴露后2 h尿比重略有减小(t=4.129,P＜0.01),pH值略有增加(t=6.530,P＜0.01).离心机检查后24 h,有1名飞行员尿MA升高,1名飞行员尿α1M升高,1名飞行员尿常规10项检测检出少量红细胞,+Gz暴露后24 h尿比重及pH值与暴露前比较差异不显著.与离心机检查前比较,检查后2 h、24 h尿MA和口lM均无明显差异(t=1.616、0.376、0.640、0.422,P＞0.05).结论 中等水平+Gz暴露对少部分飞行员肾功能指标有轻微影响,个别人员可出现短暂异常,应注意加强+Gz暴露后飞行员肾功能的监测和保护.     

Cardiovascular system function in mitral valve prolapse in fighter pilots]

Echocardiogram examination of 250 young fighter pilots has revealed that 15 aviators had mitral valve prolapse (MVP) without symptoms of pronounced regurgitation. Their functional indexes of cardiovascular system at rest or dosed physical load at veloergometer tests were normal. Only in 3 pilots were marked rare supraventricular or ventricular extrasystoles during ECG monitoring or veloergometria. Performance capability of all pilots was sufficient. 13 pilots with MVP in examination of their tolerance to +Gz hypergravity at the levels of 6 G or more for 15 s had frequent polytop or group ventricular extrasystole. There was an ordinary aggravation of extrasystole in aviators with more deep and bilateral MVP. The article makes a conclusion that on the basis of medical flight expertise a thorough selection must be made concerning possibility of every pilot with MVP to carry out flight at high manoeuvring aircraft of new generation taking into account the gravity of prolapse and tolerance to high +Gz hypergravity more than 5 G.     

Anti-G training of Japanese Air Self Defense Force fighter pilots

Recently developed high-performance fighter aircraft (HPF) are capable of producing high sustained +Gz (HSG) with a rapid onset rate. This G-producing capability is now beyond human physiologic G tolerance. Many techniques to raise the tolerance to HSG have been used operationally. In order to cope with HSG effectively, the Japanese Air Self Defense Force has given high-G training for certain fighter pilots since 1982. So far, 138 pilots (62 F-15 Trainees, 76 F-4 Trainees) have completed centrifuge training at our laboratory. The 1-week program consists of: physical examination and briefing on high-G stress and its protective methods on day 1; centrifuge rides in two basic patterns--a tracking performance and a simulated aerial combat maneuver (SACM)--during the period from day 2-5; and debriefing and questionnaires on day 6. Gradual onset run (GOR) relaxed tolerance is + 5.5 +/- 0.7 Gz and rapid onset run (ROR) relaxed tolerance is + 4.9 +/- 0.6 Gz (n = 126). The difference in G tolerance between F-15 and F-4 trainees was not significant in either GOR or ROR. Loss of consciousness (LOC) occurred in 18 F-15 trainees and 15 F-4 trainees during basic patterns but all F-15 trainees met the training goal and completed the SACM pattern on day 5 without LOC. More than half of the trainees developed a variety of arrhythmias, including PVC, SVPC, A-V dissociation, S-A block, and atrial fibrillation (AF). The AF case developed WPW syndrome and atrial fibrillation followed by LOC during a 4-G warm-up pattern.(ABSTRACT TRUNCATED AT 250 WORDS)     

飞行员年度体检疾病谱比较分析

目的 比较2012年陆军航空兵直升机飞行员和空军歼击机飞行员疾病谱,分析其异同,为航卫保障提供依据. 方法 随机抽取参加2012年大体检的陆军航空兵直升机飞行员652人和空军歼击机飞行员830人,分别计算其疾病谱前10位疾病的患病率.分别按年龄分为20～29岁、30～39岁、40岁以上组,计算两个人群各年龄组疾病谱前10位疾病的患病率;计算并比较两个人群各系统疾病的患病人数及其构成比. 结果 ①陆军航空兵飞行员和空军飞行员前4位疾病均为高脂血症、脂肪肝、高尿酸血症、胆囊息肉,患病率分别是15.64％、14.57％、6.44％、5.37％和24.22％、19.85％、14.08％、9.17％.②高脂血症、脂肪肝在陆军航空兵飞行员和空军飞行员各年龄段中均排在前两位.③消化系统疾病与内分泌、营养和代谢疾病在2012年陆军航空兵飞行员和空军飞行员疾病谱中均居前两位,患病率分别是45.66％、26.91％和39.69％、28.37％. 结论 陆军航空兵飞行员主要疾病与空军飞行员基本相似;消化系统疾病及内分泌、营养和代谢疾病是本组飞行员疾病的主要类型;高脂血症、脂肪肝是其主要病种.内分泌、营养和代谢疾病成为影响陆军航空兵飞行员身体健康的重要疾病.     

G-induced visual and cognitive disturbances in a survey of 65 operational fighter pilots

INTRODUCTION: Only one previous study has assessed almost loss of consciousness (A-LOC) in operational fighter pilots, reporting an incidence rate of 14%. Research also indicates that 8-13% of pilots have experienced G-induced loss of consciousness (G-LOC). A-LOC can be as insidious as G-LOC due to the associated altered state of awareness and relative incapacitation time, making it a significant risk factor in the high +Gz environment. Royal Australian Air Force (RAAF) pilots currently fly the F/A-18 and Hawk 127, producing +Gz accelerations up to +7.5 Gz, which places these pilots at risk of both A-LOC and G-LOC. METHODS: A survey was administered to 100 active RAAF fighter pilots requesting information on G-induced visual and cognitive disturbances, A-LOC symptoms, and G-LOC. Details regarding type of aircraft, flying maneuvers performed and mission outcome were also sought. RESULTS: There were 65 RAAF fighter pilots who completed the survey (age 20-53 yr, height 168-193 cm, weight 64-110 kg, jet hours 30-5700 h). Of these pilots, 98% indicated they had experienced at least one visual or cognitive disturbance in the high G environment: gray-out 98%; black-out 29%; and A-LOC symptoms 52%, including abnormal sensation in limbs, disorientation, and confusion. There were 9% who indicated they had experienced G-LOC (50% were the pilot flying the aircraft). DISCUSSION: These findings indicate that RAAF fighter pilots are experiencing a similar rate of visual disturbances and G-LOC when compared with other air forces. However, RAAF pilots reported a much higher incidence of A-LOC compared with the only other study of operational fighter pilots.