云南省某农村地区白内障患者手术利用影响因素病例对照

Utilization of Cataract Surgery and It's Influencing Factors among Cataract Patients in Rural Yunnan Province:A Case-Control Study

目的研究丘北县和砚山县白内障患者手术利用率低的影响因素,为提高白内障患者及时手术率采取相关措施提供依据。方法采用病例-对照进行研究,选取丘北县和砚山县筛查确诊为白内障并在确诊后半年内手术的患者作为研究的病例组(手术组),在与病例组相同居住地区内以性别、年龄(±5岁)、确诊时视力(±0.2)相同,按照1:1匹配选取对照组(非手术组)。对研究对象开展电话调查,并对数据进行整理和分析。结果共调查病例组和对照组各139例,其中男性94例,女性184例,平均年龄均为69岁。病例组和对照组在人均年收入、既往史、视力方面的差异有统计学意义(P <0.05)。多因素条件Logistic回归结果显示,患者视力、既往史(患高血压/糖尿病)、治疗认知、治愈认知和家庭支持是影响白内障患者手术利用的因素(P <0.01)。结论云南省文山州丘北县和砚山县白内障患者及时手术率较低的原因主要在于视力、既往史、治疗认知、治愈认知和家庭支持。可见,除经济因素外,还需采取社区动员与帮扶、健康教育等措施提高白内障患者对手术的利用,以达到防盲、治盲的目的,提高人群生活质量。

Objective To study the factors influencing the lower surgical utilization rate of cataract patients in Qiubei County and Yanshan County,so as to provide evidences for improving the timely cataract surgery rate.Methods A case-control study was employed in this research.The patients who were diagnosed with cataract and later operated within half a year after the diagnosis in Qiu Bei County and Yanshan County were screened as the case group(surgical group).Meanwhile,according to 1:1 matching principle,a control group(non-surgical group),with consistent homogeneity characteristics as similar gender,age(±5 years old),and the diagnosed visual acuity(±0.2),was selected from the population in the same habitation area.Telephone surveys of the subjects were conducted,and data were collated and analyzed.Results A total of 139 cases for each group respectively were investigated,including 94 males and 184 females,the average age of both males and females is about 69 years old.The differences between the case group and the control group in the average annual income,past history and visual acuity were statistically significant(P<0.05).The multivariate conditional logistic regression Results showed that the visual acuity,past history of hypertension or diabetes mellitus,therapeutic cognition,cure cognition and patients'family supports were the factors that influenced the surgical utilization of cataract patients(P<0.01).Conclusion The reasons for the lower rate of cataract surgery at Qiubei County and Yanshan County in Yunnan Wenshan prefecture are mainly due to the visual acuity,past history,therapeutic cognition,cure cognition and family support.Therefore,besides economic factors,community mobilization and assistance and health education et,should be given to improve the utilization of cataract surgery in order to prevent blindness or treating blindness,and to improve the quality of life of the population.