航醫鑑定之分析與探討－飛行安全的最後把關者

Discussions and Analysis of Medical Evaluation for Flight Safety

陳健文(Chien-Wen Chen)

《中華民國航空醫學會刊》 10卷1期 (1996/06) Pp. 79-88

https://doi.org/10.7011/TAMAROC.199606.0079

摘要

我國空軍第一個IDF中隊於83年12月成軍，未來兩年內，將再陸續換裝F-16、幻象2000等高性能戰機；F-16等高性能戰機，因其高速度、高G力等特性，早已超過平常人體生理所能承受之極限，許多在一般人認爲常見且微不足道的疾病，卻可能成爲高性能戰機飛行員的致命傷。
我國空軍現役空勤人員中，近七年內的有152人會申請航醫鑑定，其中絕大多數飛行員目前仍繼續飛行原機種。在選優換裝的前提下，飛行員身體潛藏疾病之不利影響，亦是不容忽視之要項。近七年內，國軍八○七總醫院（原空軍總醫院）實施的152位空軍飛行員航醫鑑定中有21位近視、9位胃或十二指腸潰痬、23位肝炎、14位心律不整或三尖瓣脫量、8位椎間盤突出、10位地中海型貧血、2位糖尿病、1位高血脂症。這些飛行員多數符合現行空動體檢缺點免計標準，但未必當能適合擔任高性能戰機飛行員。如二尖瓣脫垂患者，因在大G環境下，可能誘發嚴重的心率不整、形成栓塞而造成突發性的腦中風、心肌硬塞，因此做美軍研究，並不適合擔任高G任務。
本文嘗試結合實務經驗、臨床醫學及航空醫學的觀念，解釋幾類常見疾病對高性能戰機飛行員可能造成的影響，以供決策者參考，並對現行航醫鑑史及基層航醫制度提出建議，希望吸引有志醫官投身航空醫學行列。

關鍵字

高性能戰機 ； 航醫鑑定 ； 缺點免計

並列摘要

Chinese Air Forec first IDF squadron was set up in Dec. 1994. within the next two years, will change to F-16, Mirage 2000...etc. high speed, high G,..etc. of F-b and other high performance aircrafts, these characteristics had already outpaced the normal with-standin strength of human physiology, Many people think that normal variation of defect is a small thing and doesn't matter, but for pilots driving hight performance aircrafts, these minor physical defcets can be the major cause of accident.
Amongst the 1,000 more pilots serving in the Air Force of our country, there are about 152 people who has applied for fly medical evaluaton in the near seven years. Now, most pilots still continue to fly the original plane. Under the prerequisite of choosing to change the best aircraft, they should not neglect the invisible problems of the pilots, which brings bad effect. In the near seven years, Air Force General Hospital among the 152 fly medical evaluation air force pilots, there are 21 who are near-sighted, nine pilots have duodenal ulcer, 23 suffers from hepatitis, 14 suffers from arrhythmia of mitral valve prolapse, eight of them suddenly suffer from herniated inter-vertebral disc, ten of them have thalasemia anemia, two have diabetes, and one have hyperlipidemia. These Pilots Mostly Meet the present physical standard of the flight physical, where these kind of defects are waiver, but they cannot meet the standard of pilots who have to fly high performance aincraft. For instance a person who suffers from mitral valve prolapse, under the environment of Higt G, may have serious heart palpitation, and infarction, sudden stroke, and mycocardium infarction. So according to the research of U.S. Air Force he is not suitable to assume the duty of hight ”G”.
This essay tries to combine the concept of practical experiences, and clinical aviation medicine, it explains few hinds of common problems which may affect the pilots of high performance aircrafts. Also serve for judges references, and provide suggestions to the current fly medical evaluation and to the bases of aviation medicine. Hoping to attract ambitious doctor to join into the fly medical career.

並列關鍵字

high performance aircraft ； medical evaluation ； vaiver defects ； of determination