青岛市李沧区6个月～3岁儿童眼病筛查结果分析
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摘要
目的早期发现儿童眼病并进行干预可以改善儿童视力。儿童眼病筛查主要集中在托幼机构和学校,筛查对象主要是针对>3岁儿童。本研究初步探讨基于社区医院6个月~3岁低龄儿童眼病筛查的模式及患病情况。方法选择2018-01-10-2018-05-19在青岛市李沧区新阳光社区、浮山社区和大枣园社区卫生服务中心进行眼部筛查的6个月~3岁儿童为研究对象。由社区医院发放儿童眼部筛查的知情告知书,登记并组织筛查,对可疑眼部异常的儿童由眼科专家在社区复查,确定需要转诊的受检儿童,将需要转诊的儿童进行登记并追踪随访。结果参加筛查的儿童共1 269名,男672名,女587名,筛查应答比例为13.64%。屈光度数筛查结果显示,中、高度远视26例(2.05%),屈光参差16例(1.26%),近视6例(0.47%);斜视检查结果显示,间歇性外斜视4例(0.32%),恒定性外斜视1例(0.01%),内斜视1例(0.01%);倒睫56例(4.41%),上睑下垂1例(0.01%),新生儿泪囊炎11例(0.87%);不同年龄段中高度远视(χ~2=3.85,P<0.05)、倒睫(χ~2=5.39,P<0.05)及新生儿泪囊炎(χ~2=4.46,P<0.05)检出情况比较,差异有统计学意义。结论以社区医院为中心的筛查-复诊模式对低龄儿童眼部检查是一种有效的方法。早期发现儿童眼部疾病并指导家长进行干预对儿童眼部健康有益。
OBJECTIVE Early screening of eye diseases in children and early intervening can improve their eyesight.Usually,the sites to perform the screening mainly locate in the kingdergarten and primarily school.The subjects who receive the screening are children aged over 3 years old.This paper focuses on the model of screening and the distribution of the eye diseases in the groups aged 6 months to 3 years old based on the district hospital.METHODS Children aged6 months to 3 years were selected from Health Service Centers of Xinyang Community,Fushan Community and Dazaoyuan Community in Licang District of Qingdao City from January 10,2018 to May 19,2018.Firstly,the informed notification were given out by the district hospital.Secondly,the information of the children who would attend the detection were registered.Thirdly,the screening were organized.The children who were suspected to have eye disorders were re-examined by the ophthalmologist in the district hospital.The referred children were decided by the ophthalmologist and the information were written down in order to follow up.RESULTS A total of 1 269 children were screened,672 males and 587 females.The screening response rate was 13.64%.The results of diopter screening showed that 26 cases(2.05%)had moderate and high hyperopia,16 cases(1.26%)had anisometropia,6 cases(0.47%)had myopia,4 cases(0.32%)had intermittent exotropia,1 case(0.01%)had constant exotropia,1 case(0.01%)had esotropia,56 cases(4.41%)had trichiasis and1 case(0.01%)had ptosis.There were 11 cases(0.87%)of neonatal dacryocystitis.There were significant differences in moderate and high hyperopia(χ~2=3.85,P <0.05),trichiasis(χ~2=5.39,P <0.05)and neonatal dacryocystitis(χ~2=4.46,P<0.05)between different age groups.CONCLUSIONS The screening-reexamined model based on the district hospital to examine the young children's eye diseases is an effective way.Earlier Screening to find the eye disorder and to guide the parents are benefits for the children's eye health.
OBJECTIVE Early screening of eye diseases in children and early intervening can improve their eyesight.Usually,the sites to perform the screening mainly locate in the kingdergarten and primarily school.The subjects who receive the screening are children aged over 3 years old.This paper focuses on the model of screening and the distribution of the eye diseases in the groups aged 6 months to 3 years old based on the district hospital.METHODS Children aged6 months to 3 years were selected from Health Service Centers of Xinyang Community,Fushan Community and Dazaoyuan Community in Licang District of Qingdao City from January 10,2018 to May 19,2018.Firstly,the informed notification were given out by the district hospital.Secondly,the information of the children who would attend the detection were registered.Thirdly,the screening were organized.The children who were suspected to have eye disorders were re-examined by the ophthalmologist in the district hospital.The referred children were decided by the ophthalmologist and the information were written down in order to follow up.RESULTS A total of 1 269 children were screened,672 males and 587 females.The screening response rate was 13.64%.The results of diopter screening showed that 26 cases(2.05%)had moderate and high hyperopia,16 cases(1.26%)had anisometropia,6 cases(0.47%)had myopia,4 cases(0.32%)had intermittent exotropia,1 case(0.01%)had constant exotropia,1 case(0.01%)had esotropia,56 cases(4.41%)had trichiasis and1 case(0.01%)had ptosis.There were 11 cases(0.87%)of neonatal dacryocystitis.There were significant differences in moderate and high hyperopia(χ~2=3.85,P <0.05),trichiasis(χ~2=5.39,P <0.05)and neonatal dacryocystitis(χ~2=4.46,P<0.05)between different age groups.CONCLUSIONS The screening-reexamined model based on the district hospital to examine the young children's eye diseases is an effective way.Earlier Screening to find the eye disorder and to guide the parents are benefits for the children's eye health.
引文
[1]董益萍,沙吉达,朱剑锋,等.上海市社区学龄前儿童初级眼保健模式探讨[J].中国初级卫生保健,2014,28(1):29-33.
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[8]Okoye O,Umeh RE,Ezepue FU.Prevalence of eye diseases among school children in a rural south-eastern Nigerian community[J].Rural Remote Health,2013,13(3):2357.
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[10]Azizoglu S,Crewther SG,erefhan F,et al.Evidence for the need for vision screening of school children in Turkey[J].BMC Ophthalmol,2017,17(1):230.
[11]李月平,张伟.关注间歇性外斜视治疗的焦点问题[J].中华眼视光学与视觉科学杂志,2018,20(5):257-260.
[12]肖文琦.睦岗社区卫生服务中心对学龄前儿童视力筛查结果分析[J].临床医药文献电子杂志,2016,3(6):1164-1165.
[13]陆莉英,陈佳玥.社区开展学龄前儿童视力筛查的意义及防治对策研究[J].中国初级卫生保健,2017,31(1):47-48.
[14]薛丽丽,黄俊,李云,等.上海闵行区儿保门诊婴儿眼病筛查结果分析[J].中国儿童眼保健杂志,2015,23(2):215-217.
[15]John DD,Paul P,Kujur ES,et al.Prevalence of refractive errors and number needed to screen among rural high school children in Southern India:A cross-sectional study[J].J Clin Diagn Res,2017,11(8):NC16-NC19.
[2]刘国华,黄静,韩明磊,等.济南市3~6岁儿童群体中常见眼病患病率调查[J].中国斜视与小儿眼科杂志,2017,25(3):11-14.
[3]李兰,李丽红,赵艾兰,等.5 875名学龄前儿童眼病调查结果分析[J].中国儿童保健杂志,2008,16(1):121-122.
[4]赵堪兴,史学峰.学习新版临床指南进一步规范弱视诊断治疗[J].中华眼科杂志,2014,50(7):481-484.
[5]张湘雯,屈艳梅,张兰英.北京市海淀地区小学生近视现况调查与影响因素分析[J].国际眼科杂志,2018,18(8):1477-1479.
[6]Alrahili NHR,Jadidy ES,Alahmadi BSH.Prevalence of uncorrected refractive errors among children aged 3-10years in western Saudi Arabia[J].Saudi Med J,2017,38(8):804-810.
[7]Chew FLM,Thavaratnam LK,Shukor INC,et al.Visual impairment and amblyopia in malaysian pre-school children-The SEGPAEDS study[J].Med J Malaysia,2018,73(1):25-30.
[8]Okoye O,Umeh RE,Ezepue FU.Prevalence of eye diseases among school children in a rural south-eastern Nigerian community[J].Rural Remote Health,2013,13(3):2357.
[9]成洋阳,盛湘云,罗中文.0~6岁儿童眼病筛查分析[J].中国儿童保健杂志,2014,22(2):210-212.
[10]Azizoglu S,Crewther SG,erefhan F,et al.Evidence for the need for vision screening of school children in Turkey[J].BMC Ophthalmol,2017,17(1):230.
[11]李月平,张伟.关注间歇性外斜视治疗的焦点问题[J].中华眼视光学与视觉科学杂志,2018,20(5):257-260.
[12]肖文琦.睦岗社区卫生服务中心对学龄前儿童视力筛查结果分析[J].临床医药文献电子杂志,2016,3(6):1164-1165.
[13]陆莉英,陈佳玥.社区开展学龄前儿童视力筛查的意义及防治对策研究[J].中国初级卫生保健,2017,31(1):47-48.
[14]薛丽丽,黄俊,李云,等.上海闵行区儿保门诊婴儿眼病筛查结果分析[J].中国儿童眼保健杂志,2015,23(2):215-217.
[15]John DD,Paul P,Kujur ES,et al.Prevalence of refractive errors and number needed to screen among rural high school children in Southern India:A cross-sectional study[J].J Clin Diagn Res,2017,11(8):NC16-NC19.