摘要
目的 回顾性分析飞行人员特发性震颤(essential tremor,ET)的临床特点和航空医学鉴定结果,以期为飞行人员ET的治疗和航空医学鉴定提供思路。方法 采用回顾性研究,通过近10年空军特色医学中心的电子病例检索系统和国内外医学文献数据库检索飞行人员7例ET的病例或临床研究报告,对患者一般状况、临床表现、治疗措施、预后和航空医学鉴定等资料进行分析。结果 共检索到7例ET飞行人员,年龄27~43岁,均为男性。武控师1例,直升机飞行员3例,教练机飞行员2例,歼击机飞行员1例。根据震颤临床分级,1级3例,2级2例,3级1例,1例文献报道分级不详。震颤临床分级1级的2例直升机飞行员和1例教练机飞行员未治疗,航空医学鉴定结论为飞行合格。震颤临床分级为2级的1例武控师经加巴喷丁治疗后震颤临床分级为1级,航空医学鉴定结论为飞行合格;1例直升机飞行员经阿罗洛尔治疗后震颤临床分级为0级,航空医学鉴定结论为飞行合格;震颤临床分级为3级的1例教练机飞行员,航空医学鉴定结论为飞行不合格;文献报道的1例未分级歼击机飞行员被批准限双座机飞行合格。6例住院飞行人员进行了5~31个月随访,临床分级均无变化,无药物不耐受情况,飞行状态良好。结论 飞行人员ET需按照震颤临床分级科学评估,震颤分级为1级和2级的飞行人员可予以飞行合格。建议航空医学鉴定为飞行合格的飞行人员每年返院复查评估。
Objective To review the clinical characteristics and results of aeromedical assessment of aircrews with essential tremor(ET)in order to provide references for related assessments.Methods Cases of ET among aircrews and clinical reports were retrieved from the electronic case system in our center and from related databases.The conditions,clinical manifestations,treatment regimens,prognosis and aeromedical assessment of these aircrews were summarized.Results Seven male cases were enrolled in this study,who ranged from 27 to 43 in age.Among these patients,there were 3 helicopter pilots,2 instructor pilots,1 weapons controller,and 1 fighter pilot.In terms of clinical tremor grading,2 patients were rated as level 2,3 as level 1,1 as level 3,and 1 case had an unknown grading(not recorded in the literature).The three pilots graded as level 1(two helicopter pilots and one instructor pilot)were not treated and given special flight permit after aeromedical assessment.One military weapon controller and one helicopter pilot,both graded as level 2,were treated(with gabapentin and arotinolol respectively)before being given special flight permit.One pilot graded as level 3 was considered disqualified for flying,while the one case who could not be graded in literature was approved to be qualified for flying double-seat aircraft.The follow-up for the six hospitalized aircrews ranged from 5 to 31 months.There were no changes in clinical grading,no drug intolerance,and they were healthy enough for flying.Conclusion Limb tremor associated with ET in aircrews can impact flight safety and requires accurate assessment based on clinical grading.Aircrews with tremor grades 1 and 2 may be granted special flight permit.It is recommended that aircrews given special flight permit return to the hospital for annual re-assessment.
作者
石冰心
杨芬
张莹
尹延伟
赵梦娇
张光运
SHI Bingxin;YANG Fen;ZHANG Ying;YIN Yanwei;ZHAO Mengjiao;ZHANG Guangyun(Department of Neurology,Air Force Medical Center,Air Force Medical University,PLA,Beijing 100142,China)
出处
《空军航空医学》
2026年第1期10-13,共4页
AVIATION MEDICINE OF AIR FORCE
