泌尿系統結石之航空醫學考量及缺點免計探討

泌尿道結石是臨床上常見的疾病，在我國盛行率約9.6%，且男性大於女性。其症狀和相對應的治療可大可小，小至無症狀只需保守治療靜待排出，大至劇烈疼痛引發失能，甚至需手術取出。嚴重者甚至會引發泌尿道阻塞，進而導致水腎、腎衰竭、泌尿道感染和敗血症。即使經過治療，也仍有不低的復發率。由於無法預測結石何時會發作，一旦在飛行中引發劇痛造成失能，將可能造成飛安事故，對於飛行員本身和國軍甚至民眾的財產安全都是個不確定威脅。因此在航空醫學的考量上，針對罹患泌尿道結石的飛行員，應嚴格評估是否適合繼續飛行，或核予缺點免計。

關鍵字

腎結石；泌尿道結石；腎絞痛；飛行失能；缺點免計；航空醫學考量

並列摘要

Urinary tract stone or calculi is a common disease with a prevalence rate of about 9.6% in Taiwan, and men are affected more frequently than women. The treatment for the urolithiasis could differ largely depending on the presenting symptoms. If asymptomatic, patients with urolithiasis need only conservative therapy. On the other hand, urinary calculi could induce unbearable pain leading to incapacitation, then surgical intervention would be required. In severe cases or if leave untreated, urolithiasis could lead to urinary tract obstruction, hydronephrosis, acute kidney injury, urinary tract infection and sepsis. Even the disease had been cured, the high recurrence rate should be noted. It is difficult to predict when renal colic will attack and cause in-flight incapacitation, thus urinary tract stones are of major flight safety concern. Pilots with urinary tract stones should be examined to evaluate underlying causes and treated. For those with high risk of obstruction, intervention is recommended. Waiver may be granted if aeromedical evaluation suggest low risk of colic attack.

並列關鍵字

Kidney calculi ； urinary tract stones ； renal colic ； in flight incapacitation ； aviation medical concern

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