CAJ | 학술논문

目的对上海市杨浦区学龄前儿童进行弱视情况调查,并分析在新的诊断标准下学龄前儿童中弱视的患病率及分布情况.方法横断面调查研究.抽取上海市杨浦区96所幼儿园3～6岁儿童13 288名,进行视力、屈光状态检测.采用2011年新的弱视诊断标准来评价学龄前儿童弱视患病率,采用卡方检验和趋势卡方检验进行统计学分析,评价该研究人群弱视的分布情况.结果按照2011年的弱视诊断标准,上海市杨浦区学龄前儿童弱视患病率为0.91％,显著低于按照1996年弱视诊断标准所计算出的63.52％的弱视患病率(McNemar检验统计值为8320,P＜0.01).在所有弱视患儿中,屈光不正性弱视占72.7％,屈光参差性弱视占14.5％,斜视性弱视占9.1％,形觉剥夺性弱视占3.6％.4～5岁年龄段学龄前儿童弱视患病率较高(x2=27.52,P＜0.01),而不同性别间弱视患病率没有差异(x2=0.41,P＞0.05).结论上海市杨浦区学龄前儿童弱视的主要原因分别为屈光不正、屈光参差、斜视和形觉剥夺.新的诊断标准将年龄纳入了学龄前儿童的弱视诊断中,考虑到了幼儿视力发育规律在弱视诊断中的重要性,从而避免弱视诊断扩大化及过度治疗.
목적 대상해시양포구학령전인동진행약시정황조사,병분석재신적진단표준하학령전인동중약시적환병솔급분포정황.방법 횡단면조사연구.추취상해시양포구96소유인완3～6세인동13 288명,진행시력、굴광상태검측.채용2011년신적약시진단표준래평개학령전인동약시환병솔,채용잡방검험화추세잡방검험진행통계학분석,평개해연구인군약시적분포정황.결과 안조2011년적약시진단표준,상해시양포구학령전인동약시환병솔위0.91％,현저저우안조1996년약시진단표준소계산출적63.52％적약시환병솔(McNemar검험통계치위8320,P＜0.01).재소유약시환인중,굴광불정성약시점72.7％,굴광삼차성약시점14.5％,사시성약시점9.1％,형각박탈성약시점3.6％.4～5세년령단학령전인동약시환병솔교고(x2=27.52,P＜0.01),이불동성별간약시환병솔몰유차이(x2=0.41,P＞0.05).결론 상해시양포구학령전인동약시적주요원인분별위굴광불정、굴광삼차、사시화형각박탈.신적진단표준장년령납입료학령전인동적약시진단중,고필도료유인시력발육규률재약시진단중적중요성,종이피면약시진단확대화급과도치료.
Objective To investigate the amblyopia status of preschool children in the Yangpu district of Shanghai,and to analyze the incidence and distribution of amblyopia based on a new diagnostic standard.Methods Using a cross-sectional investigation method,13 288 children aged 3 to 6 years who were enrolled in 96 kindergardens in the Yangpu District of Shanghai were included in this investigation.Visual acuity and refractive status were examined,and the incidence of amblyopia was evaluated using a new diagnostic criteria.Subsequently,the distribution of amblyopia was evaluated by a chi-square test and trend chi-square test.Results The incidence of amblyopia was much higher when using the old criterion compared to the new one (63.52％ and 0.91％,respectively,P＜0.01).In this cohort study of amblyopia,refractive error amblyopia accounted for 72.7％,anisometropic amblyopia accounted for 14.5％,strabismic amblyopia accounted for 9.1％,and deprivation amblyopia accounted for 3.6％.The incidence of amblyopia was much higher in 4-5 year olds (x2=27.52,P＜0.01),but there was no difference in the incidence of amblyopia between genders (X2=0.41,P＞0.05).Conclusion The main reasons for amblyopia in preschool children in the Yangpu District were refractive error,anisometropia,strabismus and deprivation amblyopia.Taking into account the importance of visual development patterns in the diagnosis of amhlyopia in children,age was considered as a factor in the diagnosis of amblyopia based on the new diagnostic criterion.This avoided a higher number of amblyopia diagnoses and excessive treatment.