一起民航客机飞行颠簸事件的医学分析

Medical analysis of a flying turbulence accident on civil aviation aerobus

目的分析一起飞行颠簸事件发生经过和相关伤员的伤情并探讨现代综合医疗救护方法。方法对一起严重飞行颠簸事件的伤员伤情及急救处理进行回顾性医学分析。结果 2007年7月6日,南方航空公司一架 A330执行 CZ322悉尼-广州航班任务时,在高度 FL350巡航期间,距Molly(马尼拉区域)航路点约100海里(1海里=1852 m)时,遇晴空湍流发生严重颠簸,造成机上37人不同程度受伤。其中9名为机组乘务员,占机组成员60%;其余28名为旅客,占旅客人数的13%。伤情以头面部和颈部外伤最多,其次为四肢外伤,以皮肤软组织损伤为主,没有脏器损伤及骨折。直接致伤原因为晴空湍流造成飞机颠簸后的机械损伤。事件发生后,机组人员机上进行初步伤情确认及紧急处理。飞机降落在白云机场后,机场急救中心相关人员上机初步救助及转运伤员,南方航空公司航卫中心工作人员进行伤员分类转运,民航广州医院及广州当地有关医院对伤员进行进一步检查及治疗。以上所有环节完成及时,配合良好。伤员均得到及时完善的救治,现已全部痊愈或好转。结论①突发的晴空湍流难以发现,对飞行安全威胁很大;②紧急医疗救援的组织管理非常重要;③飞行事故医疗救护的应急组织方案和医疗救援能力非常关键;④对旅客和机组人员要加强安全和防护教育;⑤对受伤乘务员的体检鉴定应注意受伤部位的功能恢复情况;⑥应加强伤员的心理创伤的应急干预和康复工作。

Objective To analyze the course of flying accident and injury condition of the wounded persons, as well as to investigate the methods of modern general medical rescue. Methods A severe flying turbulence accident was analyzed retrospectively. Results On July 6th 2007, 37 persons were injured on flight CZ322 of China Southern Airlines from Sydney to Guangzhou, owing to severe clear air turbulence encountered at 100 miles （1 mile=1852 m） from the waypoint Molly on the flight level 350 when the aircraft was cruising. The injured persons included 9 air attendants （60% of aircrew members） and 28 passengers （13% of all passengers）. The major injuries were trauma of head, face, neck, and then the trauma of limbs. Most were soft tissue injuries. Organic injury and bone fracture were not found. The reason for the injuries was mechanical injury due to severe flying clear air turbulence. The injury condition was evaluated and emergency procedure was conducted by the aircrew immediately. The personnel from Airport Emergency Response Center went onboard for initial medical treatment and then transported injured passengers to Civil Aviation Guangzhou Hospital, and then the personnel from Aviation Medicine Center of China Southern Airlines transported some injured passengers to regional hospitals according to their injury conditions. Civil Aviation Guangzhou Hospital and relative regional hospitals carried out comprehensive examination and medical treatment to the injured passengers. All the injured persons had recovered due to timely treatment after the accident, quick and efficient response of related organizations and personnel, as well as good cooperation of Airport Emergence Response Center and regional hospitals. Conclusions （1）Sudden clear air turbulence is difficult to be anticipated and discovered, which is a great threat to aviation safety; （2）the organization and management of emergency medical treatment is very important; （3）emergency handling plan and medical rescue capacity are key factors; （4）safety and precaution education to passengers and air crew members are important; （5）the recovery condition of injured air attendants shall he noticed in their medical examination; （6）the recovery from psychological impact of the injured shall be noticed in medical treatment.