中美空军飞行学员医学选拔对照实证研究——晶状体浑浊
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摘要
目的筛查我军招飞体检定选中因晶状体浑浊淘汰学员按美军标准的合格率,并对中美空军的医学选拔标准进行合理探讨,提出我军标准修改建议。方法统计我军2012~2015年招飞体检定选学员眼科及晶状体浑浊不合格情况,并参考美军招飞医学标准,对不合格人员重新纳入选拔并对结果进行统计分析。结果近4年我军招飞体检学员因晶状体浑浊不合格的构成比自2013年后呈上升趋势,各年差异显著(2=9.165,P<0.05)。其中,因晶状体前膜色素超标不合格的构成比呈上升趋势,但变化幅度不大,各年比例无显著性差异(2=4.234,P=0.237);因先天性晶状体浑浊不合格的构成比近4年均值为4.4%,在2015年上升至6.92%,各年比例无显著性差异(2=6.379,P=0.095)。参考美军医学标准,先天性晶状体浑浊淘汰的学员拟保留的人数比例近4年均值为67.5%。结论美军招飞医学选拔标准较我军宽泛、具体、合理,并主要侧重功能学指标。建议我军适当地放宽标准,将具有不影响视力的单纯晶状体浑浊的边缘性学员暂时通过体检,并对其纳入标准是否影响飞行的潜在危险性进行前瞻性预后研究,同时应严格把关囊性浑浊的学员,逐级加强晶状体囊性浑浊的筛查及对比敏感度、立体视觉等视功能的筛查,此举将不仅确保录入学员飞行的安全性,又可对生源的紧张程度带来缓解,且意义深远。
Objective To screen the virtual qualified rate of our disqualified students by the American medical standard directory on lens opacity and to discuss the similarities and differences of the medical standard directory between PLA Air Force( PLAAF) and the United States Air Force( USAF). Methods The disqualified rates of ophthalmology and lens opacity and the qualified rates of our unqualified cadets were surveyed with reference to the American medical standard directory between 2012 and 2015 before the results were statistically analyzed. Results Between 2012 and 2015,the disqualified constituent rate of lens opacity increased since 2013( 2= 9. 165,P < 0. 05). The disqualified constituent rate of congenital lens opacity rose to 6. 92% in 2015,but there was no difference over the recent four years( 2= 6. 379,P =0. 095),or in lens membrane opacity( 2= 4. 234,P = 0. 237). According to the American medical standard directory,nearly 67. 5% of our disqualified cadets caused by congenital lens opacity were retained. Conclusion The American medical standard directory is broad,specific,rational,and focuses on the function index. We suggest that we should broaden our medical standard directory,especially in simple lens opacity that does not affect vision. Standards on lens membrane opacity should be strengthened,and examinations of contrast sensitivity,stereoscopic vision and other visual functions should be improved.
Objective To screen the virtual qualified rate of our disqualified students by the American medical standard directory on lens opacity and to discuss the similarities and differences of the medical standard directory between PLA Air Force( PLAAF) and the United States Air Force( USAF). Methods The disqualified rates of ophthalmology and lens opacity and the qualified rates of our unqualified cadets were surveyed with reference to the American medical standard directory between 2012 and 2015 before the results were statistically analyzed. Results Between 2012 and 2015,the disqualified constituent rate of lens opacity increased since 2013( 2= 9. 165,P < 0. 05). The disqualified constituent rate of congenital lens opacity rose to 6. 92% in 2015,but there was no difference over the recent four years( 2= 6. 379,P =0. 095),or in lens membrane opacity( 2= 4. 234,P = 0. 237). According to the American medical standard directory,nearly 67. 5% of our disqualified cadets caused by congenital lens opacity were retained. Conclusion The American medical standard directory is broad,specific,rational,and focuses on the function index. We suggest that we should broaden our medical standard directory,especially in simple lens opacity that does not affect vision. Standards on lens membrane opacity should be strengthened,and examinations of contrast sensitivity,stereoscopic vision and other visual functions should be improved.
引文
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[2]Sasaki H,Kawakami Y,Ono M,et al.Localization of cortical cataract in subjects of diverse races and latitude[J].Invest Ophthalmol Vis Sci,2003,44(10):4210-4214.
[3]Tao F,Powers-Risius P,Alpen EL,et al.Radiation effects on late cytopathological parameters in the murine lens relative to particle fluence[J].Adv Space Res,1994,14(10):483-491.
[4]鲍莉,赵飞,许唫唫.招飞体检眼科质量控制的几点体会[J].实用医药杂志,2013,30(2):160-161.
[5]张作明.航空航天临床医学[M].西安:第四军医大学出版社,2005:88.
[6]安晶,葛雪松,张作明,等.174名军事飞行人员眼科疾病检出分析[J].中华航空航天医学杂志,2014,25(3):209-211.
[7]邹志康,张凌,马中立,等.军事飞行学员医学选拔标准的构建[J].解放军医院管理杂志,2014,21(1):11-14.
[8]邹志康,刘庆元,马中立.不同远视力组飞行学员招飞选拔相关指标分析[J].武警医学,2014,2:136-138.
[9]United States Air Force.AFI 48-123,Medical Standards Directory[S].2014.
[10]Thompson J,Lakhani N.Cataracts[J].Primary Care,2015,42:409-423.
[11]陈瑞英.儿童先天性白内障及视力恢复[J].中国斜视与小儿眼科杂志,1994,2(2):89-93.