中美空军飞行学员医学选拔对照实证研究——角膜异常

目的 筛查我军定选因角膜原因淘汰学员按美军标准的评估情况,并对中美两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其角膜原因不合格情况,并参考美军招飞医学标准,对不合格人数拟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角膜疾病不合格淘汰的构成比在2013年后有所下降,各年差异均有统计学意义(χ2=21.55,P＜0.05).同时,近4年因角膜浑浊及角膜屈光矫正史淘汰人数位列前位.参考美军标准后,因角膜云翳、斑翳、角膜内皮浑浊、角膜炎不合格淘汰的学员保留比率较高,均＞60%;然而,角膜塑形镜佩戴史及角膜屈光手术史不合格学员均不符合拟保留条件.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.建议我军招飞体检可适当放宽医学标准,纳入陈旧性不影响视力的角膜浑浊者,并完善关于对比敏感度、立体视觉等视功能检查.且应加紧研究我军角膜屈光手术对军事飞行的影响,进而建立一套系统地适合我军招飞学员及飞行人员的屈光手术标准.

An empirical study on medical selection of flying cadets with corneal issues between PLAAF and USAF

Objective To screen the virtual qualified rate of disqualified students in Chinese army schools by the American medical standard directory on corneal, and to discuss the similarities and differences of medical standard directory between PLAAF and USAF.Methods We surveyed the disqualified constituent radio of the qualified rates of our unqualified cadets in Chinese army by referring to the American medical standard directory during 2012—2015, and then results were statistically analyzed.Results During 2012—2015, the disqualified constituent ratio of corneal declined from 2013 (χ2=21.55,P＜0.05); the disqualified cadets of corneal opacity and corneal refractive correction history were on the top position of all disqualified issues on corneal; upon referring to the American medical standard directory, the nebula, macula, corneal endothelial opacity, keratitis had the higher retention ratio, all of which were higher than 60%, no one retained unqualified cadets of corneal refractive correction history.Conclusion The American medical standard directory was broad, specific, reasonable, and focused mainly on the function index. We suggest that we should broaden our medical standard directory, especially in simple corneal opacity that does not affect vision and the examinations of contrast sensitivity, stereoscopic vision and other visual functions should also be improved, meanwhile, we should expedite the process on corneal refractive surgery under flight environment, and establish the medical standard directory that is suitable for our cadets.