CAJ | 학술논문

目的通过对在校中小学生包括小学1年级至高中3年级的12个年级近视患病率及程度构成比的变化趋势进行调查,观察在校学生近视化形成的自然病程.方法采用自动验光仪(NIKON SPEEDY-K)对中小学生5757人(男生2978人,占51.7％,女生2779人,占48.3％.)动态眼屈光状态等指标进行采集,输入编辑的专项应用程序,用SPSSll.0软件行统计分析.结果正视眼不断近视化,近视程度由轻度逐渐发展到中度.7岁进入近视化-0.78 D,高中三年时的平均-3.57 D达到中度近视水平.7～18岁12年间年近视化幅度为-0.22 D.学生的近视化年增长在13岁和16岁有2个缓进,在10岁、15岁和18岁有3个递增.女生先进入近视化,男生随之,最终在18岁趋于一致.右眼先进入近视化,左眼随之,最终在18岁趋于一致.结论在校期间7～ 18岁的-3.0 D眼球近视化是正常青少年发育过程中眼球从22 mm到23 mm的1 mm增长结果,并不因为近距离阅读而增加.中国的过度近视化关键是青少年丧失了对其正常的缓冲补偿能力,即3～6岁间的+3.0 D远视缓冲和22.5 mm以内的眼轴程度控制.故而提出近视防控策略:(1)过度过早的眼球正视化指导近视的预测性,学龄前充足的远视缓冲可以减少近视形成.(2)儿童青少年近视的发育性、进行性的临床意义在于树立学龄期的12年持续对近视控制的观念,并提出儿童青少年屈光度的分类建议.(3)提出眼球屈光发育的“预测公式”和近视防控的“关键年龄点”.
목적 통과대재교중소학생포괄소학1년급지고중3년급적12개년급근시환병솔급정도구성비적변화추세진행조사,관찰재교학생근시화형성적자연병정.방법 채용자동험광의(NIKON SPEEDY-K)대중소학생5757인(남생2978인,점51.7％,녀생2779인,점48.3％.)동태안굴광상태등지표진행채집,수입편집적전항응용정서,용SPSSll.0연건행통계분석.결과 정시안불단근시화,근시정도유경도축점발전도중도.7세진입근시화-0.78 D,고중삼년시적평균-3.57 D체도중도근시수평.7～18세12년간년근시화폭도위-0.22 D.학생적근시화년증장재13세화16세유2개완진,재10세、15세화18세유3개체증.녀생선진입근시화,남생수지,최종재18세추우일치.우안선진입근시화,좌안수지,최종재18세추우일치.결론 재교기간7～ 18세적-3.0 D안구근시화시정상청소년발육과정중안구종22 mm도23 mm적1 mm증장결과,병불인위근거리열독이증가.중국적과도근시화관건시청소년상실료대기정상적완충보상능력,즉3～6세간적+3.0 D원시완충화22.5 mm이내적안축정도공제.고이제출근시방공책략:(1)과도과조적안구정시화지도근시적예측성,학령전충족적원시완충가이감소근시형성.(2)인동청소년근시적발육성、진행성적림상의의재우수립학령기적12년지속대근시공제적관념,병제출인동청소년굴광도적분류건의.(3)제출안구굴광발육적“예측공식”화근시방공적“관건년령점”.
Objective To observe the course of myopization during 12 years schooldays.Methods A total of 5757 students in 4 primary schools and middle schools were examined.The collected data included object ophthalmic examinations,which were non-cycloplegic objective refraction,visual acuity,intraocular pressure,fundus evaluation,weight,height,and the special designed questionnaire investigation.The special designed inventory scale was filled in and input special computer program,then the data were statistically analyzed with SPSSll.0.Results The emmetropization shifted to myopization gradually during 12 years' schooldays,and from low myopia to moderate myopia continually.Myopization began at 7 years old and progressed to moderate degree at 18 years old with the-0.22D average increase per year.There were 2 slow-down periods at 13-and 16-year-old and 3 speed-up periods at 10-,15-,18-year-old.Conclusions Early onset myopization or over-emmetropization may guide our prediction of myopia,that is,enough hyperopia may buffer the myopic shift to reduce the myopic development.The ocular features of development and progression in schoolchildren implicate us to set up a concept of persistent control.For this purpose,we suggest a schoolchildren' classification of refractive error and set a predict formula and key point of myopia control.