经济欠发达地区糖尿病眼病的防盲治盲初步实践

Preliminary practice of blindness prevention and treatment for diabetic eye diseases in economic less-developed areas

目的:在经济欠发达地区(国家级、省级贫困县、市、区)实施糖尿病眼病的宣传教育、筛查、诊断及治疗并在与国际眼科学会、美国礼来公司和北大眼科中心指导加盟下的项目中总结创造出一种符合中国国情的、易于普及推广的、操作性强的工作模式。方法:以医院的眼后节中心为大本营,在临床诊治中加强对已确诊患者及家属的宣教指导;与当地的糖尿病医院强强联合,充分利用他们的病源优势进行有针对性的干预;借助当地卫生主管部门的行政手段建立延伸至县-乡-村的四级网络,采用分层整群的方法获得比较详尽的流行病学资料;发放宣传手册,专题讲座,乡村医生的培训,流行病学调查。结果:糖尿病眼病(本院资料)的认知率由3.2%提高至10.54%;干预率由10.8%提高至23.47%;盲目率(双)由10.0%下降至2.46%;胰岛素的使用率由10.0%提高至52.38%。结论:在经济欠发达地区实施糖尿病眼病的防盲治盲必须因地制宜,因事制宜,有很强的可操作性及顺应性才能普及推广。

AIM： To propagate, screen, diagnose and treat for diabetic eye diseases in economic less-developed areas （national and provincial poverty-stricken county, city and district）, and create a working way that be accord with China＇s national conditions and easy to achieve with the help of International Federation of Ophthalmological Societies, Eli Lilly and Company and Ophthalmic center of Peking University. METHODS： Improving propaganda to confirm patients and families in clinical diagnosis and treatment, and depending on department for posterior eye of hospitals; Cooperating with local diabetes hospitals, and intervening specifically with the help of these hospitals; Acquiring detailed epidemiological data in the way of stratified one - stage cluster sampling, utilizing administrative means of local health authorities; Issuing publicity manuals, carrying out lectures, training rural doctors and conducting epidemiological surveys. RESULTS： Awareness rate of diabetic eye diseases was enhanced from 3.2% to 10.54%, intervention rate was enhanced from 10.8% to 23.47%, blind rate （double） was decreased from 10.0% to 2.46%, and utilization rate of insulin was enhanced from 10.0% to 52.38%. CONCLUSION ： Blindness prevention and treatment fordiabetic eye diseases in economic less-developed areas should be local, flexible and easy to operate, and then the work could be popularized.