Jennings R T
Preventive, Occupational and Environmental Medicine, University of Texas Medical Branch, Galveston 77555-1150, USA.
J Vestib Res. 1998 Jan-Feb;8(1):67-70.
Space motion sickness is a well-recognized problem for space flight and affects 73% of crewmembers on the first 2 or 3 days of their initial flight. Illness severity is variable, but over half of cases are categorized as moderate to severe. Management has included elimination of provocative activities and delay of critical performance-related procedures such as extra-vehicular activity (EVA) or Shuttle landing during the first three days of missions. Pharmacological treatment strategies have had variable results, but intramuscular promethazine has been the most effective to date with a 90% initial response rate and important reduction in residual symptoms the next flight day. Oral prophylactic treatment of crewmembers with difficulty on prior flights has had mixed results. In order to accommodate more aggressive pharmacologic management, crew medical officers receive additional training in parenteral administration of medications. Preflight medication testing is accomplished to reduce the risk of unexpected performance decrements or idiosyncratic reactions. When possible, treatment is offered in the presleep period to mask potential treatment-related drowsiness. Another phenomenon noted by crewmembers and physicians as flights have lengthened is readaptation difficulty or motion sickness on return to Earth. These problems have included nausea, vomiting, and difficulty with locomotion or coordination upon early exposure to gravity. Since landing and egress are principal concerns during this portion of the flight, these deficits are of operational concern. Postflight therapy has been directed at nausea and vomiting, and meclizine and promethazine are the principal agents used. There has been no official attempt at prophylactic treatment prior to entry. Since there is considerable individual variation in postflight deficit and since adaptation from prior flights seems to persist, it has been recommended that commanders with prior shuttle landing experience be named to flights of extended duration.
太空晕动病是太空飞行中一个广为人知的问题，在首次飞行的头两三天会影响73%的机组人员。疾病严重程度各不相同，但超过一半的病例被归类为中度至重度。应对措施包括取消刺激性活动，并推迟关键的与任务表现相关的程序，如在任务的头三天进行舱外活动（EVA）或航天飞机着陆。药物治疗策略的效果参差不齐，但迄今为止，肌肉注射异丙嗪最为有效，初始有效率为90%，且在次飞行日残余症状有显著减轻。对之前飞行时出现困难的机组人员进行口服预防性治疗，效果不一。为了采用更积极的药物管理方法，机组医务人员接受了更多关于药物注射给药的培训。进行飞行前药物测试，以降低意外的性能下降或特异反应的风险。尽可能在睡前进行治疗，以掩盖潜在的与治疗相关的嗜睡。随着飞行时间延长，机组人员和医生还注意到另一个现象，即返回地球时重新适应困难或晕动病。这些问题包括恶心、呕吐，以及在早期接触重力时出现行动或协调困难。由于着陆和出舱是飞行这一阶段的主要关注点，这些机能缺陷关乎飞行操作。飞行后的治疗主要针对恶心和呕吐，主要使用美克洛嗪和异丙嗪。在返回前没有进行官方的预防性治疗尝试。由于飞行后机能缺陷存在相当大的个体差异，而且之前飞行形成的适应似乎会持续存在，因此建议指派有航天飞机着陆经验的指挥官执行长时间飞行任务。
