上海市宝山区5000名学生视力监测与干预情况

Visual monitoring and intervention status of 5000 students in Baoshan District,Shanghai

目的:通过监测获得宝山区中小学生视力、屈光不良情况,研究行为干预对近视发展有无影响。方法:采用整群随机抽样的方法,在上海市宝山区抽取中小学校5所,参照《眼科全书》近视诊断标准对所有学生进行视力普查,对视力低常学生使用拓普康RA800型验光仪进行电脑验光,选择基础条件相似的两所学校部分班级进行分组,加以行为干预,0.5a后对所测学生进行复查。结果:宝山区学生视力不良率高于上海市平均水平,且随年级升高呈现出阶梯性增长态势。小学生视力不良率已经达到将近50%,初中生达到了70%以上。随着年级增高,轻度屈光不良所占比例越来越低,重度屈光不良所占比例也越来越高,从一年级的10%左右增长到初二年级的30%左右。每个年级监测人群前后两次视力不良对比无统计学差异,每个年级屈光不良分级构成比前后无统计学差异。不能认为采取的干预措施对学生视力不良率的发展产生作用,但是干预对学生护眼知识方面水平的提高比较明显。结论:学生视力不良率随年级升高而逐渐升高,重度屈光不良所占比例也逐渐升高,强化行为干预对限制学生近视发展无明显作用。

·AIM：To investigate the poor eyesight situation of pupils and junior middle school students in Baoshan District,Shanghai,and to observe the impact of intervention on the development of myopia.·METHODS：Five schools were selected by randomized cluster sampling in Baoshan District,Shanghai.Eyesight was tested for all students in these five schools.Myopia was defined according to the criteria of Ophthalmonogy encyclopedia.Refraction examination was performed for the students with poor eyesight.Students from two schools with similar conditions were selected and divided in two groups,one intervention group and one control group.The eyesight was tested again after 6 months.·RESULTS：The prevalence of poor eyesight of students surveyed in Baoshan District was higher than the average prevalence in Shanghai.The prevalence of poor eyesight increased with the grade,and it was close to 50% for pupils and exceeded 70% for middle school students.The proportion of mild refractive error decreased and the proportion of severe refractive error increased with the grade,which raised from 10% of grade one to 30% of grade eight.There were neither significant differences of the prevalence of poor eyesight,nor significant differences of the proportion of refractive error between the first and the second eyesight tests for students in each grade.The comparison between the prevalence of poor eyesight before and after the intervention showed that the measures could not prevent the development of myopia,but increased the knowledge of eye protection for students.·CONCLUSION：The prevalence of poor eyesight and the proportion of severe refractive error increase with the grade for primary and middle school students.Enhanced behavior intervention has no significant effect on preventing the development of myopia.·