强化干预措施在学龄前儿童视力异常转诊中的应用效果  

Effect of intensive intervention for improving the referral rate among preschoolers with vision abnormalities

作　　者：陈佳玥 童连 刘萍 薛丽丽 陈恩培 CHEN Jiayue;TONG Lian;LIU Ping;XUE Lili;CHEN Enpei(Public Health Center,Huacao Community Sanitary Service Center in Minghang District,Shanghai(201107),China;不详)

机构地区：[1]上海市闵行区华漕社区卫生服务中心公共卫生中心,201107 [2]复旦大学公共卫生学院妇幼与儿少卫生教研室/公共卫生安全教育部重点实验室 [3]上海市闵行区颛桥社区卫生服务中心公共卫生中心 [4]上海市闵行区妇幼保健院儿保科

出　　处：《中国学校卫生》2021年第12期1892-1895,共4页Chinese Journal of School Health

基　　金：2019年闵行区自然科学研究课题(2019MHZ046);2019年复旦-闵行康联体项目研究课题。

摘　　要：目的探索对视力屈光初筛异常儿童转诊的有效干预措施,为儿童青少年近视防治工作提供线索依据。方法2019年4—6月,对上海市闵行区颛桥镇22家幼儿园共4464名学龄前儿童开展视力普查。对初筛视力异常的1724名儿童,采取分层随机整群抽样的方法,按不同幼儿园类型进行随机分层,分为干预组(896名)和对照组(828名)。干预组给予3个月的强化健康指导与卫生服务,对照组给予3个月的常规保健管理。结果2019年上海市某社区学龄前儿童视力与屈光初筛异常发生率为38.62%,其中裸眼视力异常发生率为4.40%,存在近视风险发生率为37.10%,存在远视风险发生率为2.20%,存在散光风险发生率为6.10%。干预后,干预组转诊率为68.75%,高于对照组的17.15%(χ^(2)=465.09,P<0.01);在转诊就医的儿童中前往定点医院比例,干预组为45.94%,对照组为12.68%,差异有统计学意义(χ^(2)=53.34,P<0.01)。干预后,在选择就诊医院意向上干预组与对照组差异均有统计学意义(χ^(2)值分别为10.01,51.51,15.40,27.79,19.96,24.24,P值均<0.01)。结论学龄前儿童视力与屈光现状不容乐观。实施儿童视力健康评估、儿童眼保健自我管理指导、提供社区眼保健服务等干预措施,能提高家长对儿童视力初筛异常的转诊率,对及时发现学龄前儿童视力问题、保护儿童远视储备,预防近视发生有积极作用。Objective To explore effect of intensive intervention for improving the referral rate of children with visual refractive disorders, and to provide a reference for myopia prevention and control of children and adolescents. Methods A total of 4 464 preschool children were selected from Zhuanqiao county, Minghang district in Shanghai for the eyesight investigation during April to June in 2019. Stratified random cluster sampling method was used to divide 1 724 children into intervention group and(896) control group(828) depending on the type of kindergartens. The intervention group was provied with an intensive intervention, including children’s vision health assessment, parental self-management guidance for children’s eye care, and community-based eye care services, while the control group carried out routine intervention measures. Results In 2019, the incidence of visual and primary refractive screen abnormalities in preschoolers of Zhuanqiao community was 38.62%. The incidence of naked eye vision abnormalities was 4.40%, the incidence of myopia-risk group, hyperopia-risk group and astigmatism-risk group was 37.10%, 2.20%, and 6.10%, respectively. After the intervention, the referral rate of the intervention group(68.75%) was significantly higher than that of the control group(17.15%)(χ^(2)=465.09, P<0.01). The differences between two groups were statistically significant in choosing the hospital for treatment(χ^(2)=10.01, 51.51, 15.40, 27.79, 19.96, 24.24, P<0.01). Conclusion The vision and refractive status of preschoolers worths further attention. Intensive intervention can improve the referral rate for children with screened vision abnormalities, which facilitates the prevention and early diagnosis of vision problems among preschoolers.

关 键 词：卫生措施 屈光 眼 近视 远视 干预性研究 儿童 学龄前 

分 类 号：G478[文化科学—教育学] R779.7[文化科学—教育技术学]