浙江省温州地区白内障患者就诊及时性滞后的影响因素

Impact factor of timeliness lag for seeing a doctor about cataract patient in Wenzhou region of Zhejiang province

目的调查白内障患者就诊手术及时性滞后的影响因子。方法采用机会性筛查的方法，于2007年1月至2012年1月在浙江温州地区10个县市100多个乡镇，抽取50岁以上人群开展白内障筛检。受检者接受手持式裂隙灯显微镜和直接检眼镜检查，对符合手术要求者，批量接至三级甲等眼视光医院，采用手法小切口白内障囊外摘除术为其手术；同时，针对患者的基本情况、经济状况、基本生活情况、医疗卫生情况、医疗卫生需求五大方面，设计23个有关及时眭、未及时性指标进行调查，以判断分析白内障患者就诊及时性滞后的影响因素。结果5年共筛检人数为36681例，其中10326例（10326只眼）被确诊为符合手术指征的白内障患者；在有关及时性的16个因素分析中，其中对就诊及时影响具有统计学意义的包括有无交通工具、最近医疗点距离、保健常识、家庭人口数、家庭总收入、被调查者学历、家庭成员最高学历、工作类型、房屋结构、接受政府补助等10因素。7个未及时手术原因调查发现最主要的原因是经济困难，其次分别是年龄大、怕给子女添麻烦等，三者构成比超过75％。结论眼科医生在注重高尖新手术技术的同时，应重点推广手术成本较低、手术效果好的手法小切口白内障囊外摘除术。

Objective investigation the impact factor of timeliness lag about cataract patient of operation. Methods Through Opportunistic Screening , from January 2007 to January 2012, we extracted people aged 50 or above and carried out the cataract screening in 10 towns of Wenzhou region of Zhejiang province. People extracted was checked by slit lamp microscope and ophthalmoscope directly, and the people who are suit for operation were brought to a first-rate of level three eye hospital and operated by MSICS . At the same time we have made questionnaire about five aspect including basic situation, economic status, basic life status, health and medical status and health needs for the operator and this questionnaire involves twenty- three relevant indexes about the timeliness, these factors of timeliness for patients seeing a doctor are judged. Results 36 681 people are checked for five years and 10 326 people（ 10 326 eyes） are suitable for surgery. Through analyzing sixteen relevant indexes about the timeliness , there are ten indexes which have Statistical Significance including in transportation, the distance for nearest medical aid post , care knowledge, population of family, income of family, respondents degree , the highest degree of family members type of work, structure of building, government subsidies. The first reason that the people can＇t be operated in time are economic difficulties, next are older and making children trouble for seven factors of no operation in time. The people for this three reason is more than 75% for not seeing a doctor in time. Conclusion The key work of blindness prevention and treatment is the cataract surgery for our country. Eye doctors pay attention to new surgical technique , at the same time we should promote MSICS which is technique of low cost and have good effect of the operation.