新疆库车县维吾尔族农民白内障手术的生存质量评价

Quality of life assessment of cataract surgery in Uigurs farmer population of Kuche county, Uigurs of Xinjiang District

目的评价新疆库车县年龄≥40岁维吾尔族农民白内障术后患者的主观视功能（visual function,VF）和生存质量（quality of life,QOL）。方法在整群随机抽样的2955人中,所有白内障术后患者作为手术组,部分视力正常者（双眼视力均〉0.3,每10例中按序抽取1例受检者）和视功能损害者（1只眼视力〈0.1,每3例中按序抽取1例受检者）作为对照组。该两组均接受眼科检查并由专人进行问卷调查。结果在受检的2955人中,手术组64人中62人完成问卷;对照组中,正常对照1920人中的145人和视功能损害971人中的230人完成问卷调查。手术组与对照组的VF平均得分分别为77.1和68.8;手术组与对照组的QOL平均得分分别为89.1和91.7;非手术组视力分级与VF和QOL得分的相关性高于手术组;经多因素回归分析校正了年龄、性别、文化、视力分级后,手术组与对照组的VF得分和QOL得分差异有统计学意义（两者P〈0.001）.经偏回归系数t检验,影响手术组与对照组的主要因素均为视力,其标准化偏回归系数分别为-0.731和-0.610。结论新疆库车县维吾尔族农民白内障术后VF和QOL得分无明显提高,影响的主要因素为视力。故如何切实提高白内障患者的视力是提高生存质量的重点。

Objective To evaluate the outcome of cataract surgery in Uigurs farmer population in Kuche county, Uigurs of Xinjiang District by assessment of subjective visual function and quality of life. Methods Take all cataract postoperative cases as the operate group,the control group composed of one in every three persons with visual acuity less than 0.1 in either eye and one in every ten persons with visual acuity better than 0.3 in both eye .All of those who were entered were response to the questionair developed by National Eye Institute,USA in developing countries. Results In 2955 cross-sectional examined persons, 437 persons successfully finished the paper. On a 0-100 scale ,average scores of VF and QOL were 85.4 and 93.8 for operate one and 100 and 100 for control one .After adjusted the confounding effect of visual status, age, sex and education by multivariate regression model ,the difference of VF and QOL scores between operated and un-operated group was a significant （p〈0.01）.the main influence factors is vision acuity. Conclusion Subjective visual function and quality of life could not be significantly improved after cataract surgery in the target population, the scores of VF and QOL are significantly correlated with the visual status .concerns should be paid in how to improve the visual acuity in the cataract surgery.