臺大醫院心血管中心整建工程之挑戰

The Renovation Challenges of Cardiovascular Center, National Taiwan University Hospital

馬曉悌(Hsiao-Ti Ma)

指導教授 ： 張陸滿 教授

國立臺灣大學/工學院/土木工程學研究所/碩士(2015年)

https://doi.org/10.6342/NTU.2015.00085

摘要

心臟係人體血液循環之主要動力來源，心血管係人體血液循環之主要管道與途徑。心臟、心血管出了問題，對人體相對影響隨之產生，甚或危及生命安全；不可不查、不可輕忽！
隨著國人飲食習慣逐漸西化，加上現代社會生活步調快速壓力大，國人患有高血壓、糖尿病、高血脂的比例逐漸上升，心血管疾病的發生率也逐漸增加且有年輕化的趨勢。心肌梗塞便是其中最嚴重的表現。
心導管手術是冠狀動脈疾病診斷治療中非常重要的一環，目前心導管的技術一日千里，有許多冠狀動脈疾病的病友都可以藉由氣球擴張術和放置支架而使病情有顯著的改善。有鑑於此，臺大醫院決定將落成啟用已達二十年之東址五樓，規劃改建為「臺大醫院心血管中心」，以應時勢。

然，此心血管中心之建築物改建係整建工程，面臨諸多挑戰。建築物新建時依循當時建築、結構、消防等相關之法令規範；然當舊有建築增建、改建、整建時則需依循增建、改建、整建時相關之法令規範。
新、舊法規因應時空背景及其實際需求而有所變更；又增建、改建、整建時因使用用途與空間、配置及需求之不同，而改變其原有隔局、動線，甚或是因使用需求荷重之增加，需改變其原有結構行為而施以必要性之結構補強行為。
再者，除非是原有建物全部拆除重建，若僅為局部增建或部份樓層或部份區域施以改建、整建；而其餘樓層與區域均正常且持續之使用，則所需考量因素與工程進行階段所受限制相對提高與增多。
面對限制，除事前之假設與各項因應計畫外、更於實際個案進行中隨時針對問題，研議、溝通、協調，除卻造就工程順利達成外；更兼顧工程範圍外之各環境場所之安全暨將影響層面與範圍降至最低。

關鍵字

心血管中心 ； 整建工程 ； 工程限制 ； 界面協調

並列摘要

The heart is the main power source of the blood circulation system, and the cardiovascular is the main pipeline and ways of human blood circulation. If the heart or the cardiovascular out of function, negative effects to body will be come along and even more to life-threatening.
As westernized diet was increasingly and come with high pressure stress by the fast-paced of modern life in our society that then causing the increased proportion of high blood pressure, diabetes, high cholesterol, also comes with young trend on the incidence of cardiovascular disease. Myocardial infarction is one of the most serious manifestations.
To cope with the trend and new technologies, National Taiwan University Hospital decided to renovate the existing 5th floor of the East Wing in the 20 years old hospital Building Complex into Cardiovascular Center.
The related construction project involved with remodeling the old building. New buildings are following the current laws and regulations related to architectural, structural, fire and other norms; and the current laws and regulations also specified to the old building when it needs for additions or alterations.
Old and new regulations are in response to the actual needs at the time phase and changes of surrounding. When an existing building need for additions or alterations, because of the purposes or functions of space usage, that could need to change original structure and necessity of reinforcing to impose the structure. And unless the original construction was demolished and rebuilt to follow the current laws and regulations, it will be facing more constraints and considerations with complexity required if the reinforcement to impose the structure only for the part of floors or areas and keeps the usage and functions as original for the remaining floors and areas.
When facing the restrictions, we need to have plans and lots of kind assumption in advance to be ready for questions, deliberation, communication, coordination in the actual cases. To create project successfully and make sure the in/out safety and security of the workplace and minimize the negative impact and affect.

並列關鍵字

Cardiovascular Center ； Renovation

參考文獻

●行政院衛生署衛生統計資訊網

●行政院衛生署「醫療機構設置標準」，1989。

●行政院衛生署疾病管制局負壓隔離病房作業參考手冊

●黃明生，「專案施工階段界面整合管理因素之分析與研究-以醫院建築工程為例」，碩士論文，國立台灣大學土木工程學研究所， 2008 。

●國立臺灣大學醫學院附設醫院各種工程驗收時應有之清潔標準