四川甘孜藏区50岁及以上人群白内障患病率及手术治疗情况调查  

Prevalence and surgical status of cataract in adults aged 50 years and older in Kandze Tibetan areas of Sichuan,China

作　　者：嘉初丹巴[1] 央京 蒋凤 罗莉[1] Jiachudanba;Yangjing;Jiang Feng;Luo Li(Kham Eye Centre,Kandze Prefecture People's Hospital,Ganzi Hospital,West China Hospital of Sichuan University,Kangding 626000,China)

机构地区：[1]甘孜藏族自治州人民医院眼科、四川大学华西医院甘孜医院,康定626000

出　　处：《中华实验眼科杂志》2023年第6期582-591,共10页Chinese Journal Of Experimental Ophthalmology

基　　金：四川省科技厅科学研究基金项目(2020YFS0537);四川省卫生厅科学研究基金项目(080132)。

摘　　要：目的调查四川甘孜藏区50岁及以上人群白内障患病率、手术覆盖率及术后效果等,评价该地区防盲治盲效果。方法采用横断面调查研究方法,在2017年10月至2018年4月使用可避免盲的快速评估方法(RAAB)对四川省甘孜州50岁及以上人群进行研究。参照甘孜州2010年全国第6次人口普查数据,使用RAAB软件,采用分层、整群随机抽样方法抽取50岁及以上常住居民共5000人,每个人群组为50人,共100个人群组。由2个调查小组进行调查,对所有受检者入户进行视力和眼部检查,调查白内障患病率、手术覆盖率、手术障碍和术后效果。结果5000人中,接受检查的总人数为4763人,受检率为95.3%。根据针孔矫正视力和2009年WHO视力损伤标准计算,甘孜州50岁及以上人群中双眼白内障致盲以及重度、中度和轻度视力损伤的患病率分别为0.6%(95%CI:0.4%~0.9%)、0.9%(95%CI:0.6%~1.2%)、2.4%(95%CI:2.0%~2.9%)、5.2%(95%CI:4.6%~5.9%);女性的白内障致盲患病率为0.7%(95%CI:0.4%~1.0%),显著高于男性的0.2%(95%CI:0.1%~0.5%),差异有统计学意义(P<0.05)。藏族人群的白内障致盲患病率为2.3%,高于汉族人群的1.0%,差异有统计学意义(P<0.05)。以眼数来统计,女性白内障手术覆盖率为60.8%(95%CI:55.5%~65.8%),低于男性的70.1%(95%CI:63.7%~75.7%),差异有统计学意义(P<0.05)。按人数来统计,以优势眼(双眼中视力较好眼)针孔矫正视力<0.05为盲的标准,双眼白内障致盲的白内障手术覆盖率为82.0%(95%CI:75.2%~87.6%)。共计171人未治疗白内障,并接受了白内障手术障碍问卷调查,结果显示最主要的障碍为“不知道可以接受治疗”,占77.8%;其次为交通不便或无人陪同到医院,占11.7%。共计364眼接受过白内障手术,其中336眼植入人工晶状体,人工晶状体植入率为92.3%,216眼白内障术后视力≥0.3,占59.3%。结论白内障仍是甘孜州50岁及以上人群盲的主要原因,手术治疗白内障依然是甘孜�Objective To investigate the prevalence of cataract,cataract surgical coverage and surgical outcomes in people aged 50 years and older in Kandze Tibetan areas of Sichuan Province,and to evaluate the effectiveness of the prevention and treatment of blindness in the region.Methods A cross-sectional study was conducted to study the population aged 50 years and above in Ganzi Tibetan Autonomous Prefecture,Sichuan Province,from October 2017 to April 2018 using the Rapid Assessment of Avoidable Blindness(RAAB)method.A total of 5000 permanent residents aged 50 years and older were selected using a stratified,cluster sampling method with reference to the data from the 2010 China Population Census with the RAAB software,and each cluster consisted of 50 people,for a total of 100 clusters.The survey was conducted by two survey teams,and all subjects underwent visual acuity and ophthalmic examinations at home to investigate relevant cataract prevalence,surgical coverage,surgical barriers,and postoperative outcomes according to WHO Standards.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Kandze Prefecture People's Hospital(No.GZZYY-2016-11).Written informed consent was obtained from each subject.Results Of 5000 eligible participants,4763 were examined,with a response rate of 95.3%.Referred to the visual impairment standard of WHO and the pinhole visual acuity,the prevalence of bilateral blindness,severe,moderate and mild visual impairment was 0.6%(95%[confidence interval,CI]:0.4%-0.9%),0.9%(95%CI:0.6%-1.2%),2.4%(95%CI:2.0%-2.9%)and 5.2%(95%CI:4.6%-5.9%),respectively.The prevalence of cataract blindness was 0.7%(95%CI:0.4%-1.0%)in females,significantly higher than 0.2%(95%CI:0.1%-0.5%)in males(P<0.05).The prevalence of cataract blindness was 2.3%among Tibetan,higher than 1.0%among Han Chinese,showing a statistically significant difference(P<0.05).By the number of eyes,the cataract surgical coverage was 60.8%(95%CI:55.5%-65.8%)in females,which was lower than 70.1%(95

关 键 词：白内障 患病率 手术 健康调查 可避免盲的快速调查 甘孜藏区 中国 

分 类 号：R779.66[医药卫生—眼科]