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[目的]通过跟踪监测高原列车乘务人员相关生理指标变化,分析乘务人员高原适应性及影响因素,为高原乘务人员的健康监护及指定作业方式提供依据。[方法]随机对一列京藏线列车98名乘务人员全程监测血氧饱和度(SaO2)、眼压、眼底情况及Lake Louise急性高原病(AMS)自评评分。[结果]车厢内氧分压及乘务员血氧饱和度与海拔高程呈负相关性,94人发生不同程度AMS,在岗时间短及劳动强度大的人群AMS较明显(P<0.05),83人出现视网膜静脉扩张,21人出现视乳头充血水肿。[结论]现行列车富氧措施不能完全防止AMS的发生;在岗时间及劳动强度均对乘务员高原适应性有影响;视网膜血管改变可作为AMS重要指征。
[Objective] By tracking and monitoring the changes of relevant physiological indexes of crew members on plateau trains, the suitability and influencing factors of crew altitude were analyzed to provide the basis for the health guardianship and designated operation mode of crew members in plateau. [Method] A total of 98 crew members on a Beijing-Tibet line were randomly monitored for SaO2, IOP, fundus and Lake Louise Acute Automated Plague (AMS) self-assessment score. [Results] There was a negative correlation between Oxygen partial pressure in cabin and flight attendant oxygen saturation and elevation, 94 patients had AMS in different degree, and AMS was more obvious in those who had shorter working time and labor intensity (P <0.05), 83 people appeared Retinal vein dilation, 21 patients with papilledema congestion and edema. [Conclusion] The current train oxygen enrichment measures can not completely prevent the occurrence of AMS. The occupational time and labor intensity all have an impact on flight attendant plateau adaptability. The retinal vascular changes can be used as an important indicator of AMS.