摘要
目的通过报道1例高性能战斗机飞行员延迟性耳气压伤的发病及诊疗经过,提出飞行人员延迟性耳气压伤防控和航空医学鉴定原则。方法分析1例高性能战斗机飞行员发生左侧延迟性耳气压伤治疗后复飞的临床诊治过程、随访和复飞经过,并复习国内外相关文献。结果该飞行员于2014年3月某次高空科目飞行训练过程中及训练结束后未感不适,但于次日晨起觉左耳疼痛明显。查体:左耳鼓膜轻度内陷,鼓膜中度充血,右耳未见明显异常;捏鼻鼓气双侧咽鼓管通畅,鼻咽部无异常。诊断:左耳延迟性耳气压伤。嘱该飞行员反复捏鼻鼓气,4 h后耳痛症状缓解并逐渐消失。3 d后体检未见明显异常,恢复飞行。嘱其着陆后充分吞咽鼓气,次日未再出现耳痛。随访2年,未再发生耳气压伤。结论飞行员吸氧飞行结束后,反复咽鼓管通气是防治延迟性耳气压伤的重要措施。该病治疗效果好,航空医学鉴定通常可做飞行合格结论。
Objective To improve the prevention,cure and medical evaluation of delayed aural barotrauma through one case of delayed aural barotrauma in a high performance fighter pilot.Methods The onset,diagnosis,treatment,follow up and the course of return to fight duty of one case of left delayed aural barotrauma in a high performance fighter pilot were analyzed,and related literature was reviewed.Results This high performance fighter pilot had no discomfort during the training of high altitude flight at night or after landing in March 2014,but suffered a severe pain in his left ear the next morning.The flight surgeon gave this fighter pilot a detailed checkup,only to find a mild retraction and moderate congestion of the left eardrum,but no obvious abnormalities in the right one.The functions of bilateral Eustachian tubes were normal,and had no abnormal symptoms in the nasopharynx.This pilot was diagnosed with delayed aural barotrauma.After repeated Valsalva maneuver,the pain of his left ear was eased and gradually disappeared over the next 4 hours.He returned to flight 3 days later,but was required to swallow during flight tasks and do Valsalva maneuver after landing.Such discomfort has never come back since the next day.Conclusion Delayed aural barotrauma after high altitude flight with oxygen inhalation in fighter pilots could be effectively prevented by repeated valsalva manever.
出处
《空军医学杂志》
2017年第1期20-22,共3页
Medical Journal of Air Force
基金
全军后勤科研重点项目(BKJ15J004)
