2007-2009年国航乘务员航空性中耳炎的现状调查

The investigation on aerotitis among stewards of Air China 2007-2009

目的:对确诊333例航空性中耳炎进行客观评价和疾病分析,探讨空中乘务员群体航空性中耳炎的发病率、发病因素、性别和季节的发病情况。方法:手把手的教年轻医师如何看正常耳膜、内陷耳膜、充血耳膜、穿孔耳膜。根据航空医学诊断标准,结合临床症状和物理检查,做出航空性中耳炎的诊断,并进行数据统计。利用空勤人员的急救复训课、2008奥运急救培训、新学员入队教育,向乘务员传授航空性中耳炎常识,让乘务员了解座舱压力变化和中耳的发病关系,耳膜充血、穿孔的临床特征,覆盖面达90%以上。结果:客舱航医基本掌握耳镜的物理检查手段100%,广大乘务员对航空性中耳炎基本知识的认知状况占90%,清楚占3260/3718%(87.7%),对航空性中耳炎认知状况认为很必要占3260/3718%(87.7%)。结论:①2007-2009年国航客舱乘务共诊断航空性中耳炎333人,平均每年发病111人;飞行人数3728人,占飞行人数发病率9%,平均每年发病率3%,平均每月发病9人。②冬春季发病较突出,占发病人数的57%,发病机理为鼻粘膜充血水肿,影响咽鼓管通气功能;男女性别发病差异大,女性占发病人数67%,总发病率为6%;男性占发病人数10%,总发病率为0.9%,客观反应男女肌腱、筋膜组织生理结构的差异。③航空性耳膜穿孔4例,全部为女性,占发病率1.2%,占飞行总人数0.1%。

Objective：To research the morbidity, pathogenic factors and symptoms in two genders and four seasons of aerotitis among stewards through evaluating and analyzing the 333 confirmed cases. Methods：Guiding fresh doctors how to distinguish different types of eardrum, such as perforated eardrum, congestive eardrum. Making diagnosis and data analysis is based on the diagnostic criteria. Organizing varies training programs to valorize general knowledge about aerotitis to more than 90% of all the stewards. Results：All the aviation doctors were able to handle otoscope; Over 90 % of the stewards had basic understanding about aerotitis; among the 3718 stewards,3260 of them realized the importance and necessity of general knowledge about aerotitis. Conclusion：①Aviation doctors confirmed 333 cases of aerotitis from 2007 to 2009. The morbidity is 111 per year. Patients constituted 9% of 3728 stewards in work. ②57% of the cases were confirmed in spring and winter. Nasal swelling and nasal congestion impeded Eustachian tube working normally, Female patients accounted for 67% of all the confirmed cases ,from which we learned the sex differences on tendon and fascia tissue. ③We found four eardrum perforation cases which constituted 0.1% of 3718 stewards. All the patients are women.