社区医教结合对中小学生视力健康的保护作用

Eyesight health for primary and secondary students impacted by combination of medical and educational methods in a community of Shanghai

【目的】探讨社区医教结合服务模式对中小学生视力健康的保护作用。【方法】上海市龙华社区中小学校于2013年开始实施"医教结合"。在2013年(干预前)和2015年(干预后)分别通过分层整群抽样,抽取龙华社区中小学部分年级学生,并在2015年抽取康健社区的同年级学生,检查并分析学生的视力情况。【结果】龙华社区在2013年三年级、五年级、七年级和九年级视力不良率分别为43.45%、58.14%、63.28%和73.99%(χ■=16.60,P<0.001),2015年各年级分别为35.35%、56.60%、62.07%和70.33%(χ■=40.26,P<0.001),康健社区2015年各年级分别为42.67%、63.87%、66.67%和72.04%(χ■=19.14,P<0.001);龙华社区2015年所抽取年级中新发视力不良率较2013年均有所下降(P<0.05),其中三年级(26.36%vs 3.90%)、五年级(32.84%vs 21.84%)、七年级(16.07%vs 6.10%)和九年级(32.84%vs 10.14%);龙华社区2015年新发视力不良率均低于康健社区同年级(P<0.05),其中三年级(3.90%vs 21.30%),五年级(21.84%vs 34.56%),七年级(6.10%vs 17.71%)和九年级(10.14%vs 27.78%)。【结论】社区医教结合健康服务模式可降低新发的视力不良率,对保持中小学生视力健康有积极作用。

[Objective] To explore the effect of health service model based on combination of medicine and education which may impact primary and middle school students′ eyesight health.[Methods] Students were selected from Longhua community in 2013 and 2015 and from Kangjian community in 2015 by stratified and random cluster sampling and examined for their eyesight.[Results] Prevalence of poor eyesight of Longhua community was 43.45%,58.14%,63.28% and 73.99%(χ^2趋=16.60,P<0.001) in 2013 and 35.35%,56.60%,62.07% and 70.33%(χ^2趋=40.26,P<0.001)in 2015 for primary grade three,five and junior grade seven,nine successively,42.67%,63.87%,66.67% and 72.04%(χ^2趋=19.14,P<0.001)in Kangjian community in 2015 successively.Incidence of poor eyesight of students decreased significantly in 2015 compared with that in 2013 covering different grades respectively in Longhua community(P<0.05),the group of primary school contained grade three(26.36% vs 3.90%)and grade five(32.84% vs 21.84%),the group of middle school contained grade seven(16.07% vs 6.10%)and grade nine(32.84% vs 10.14%).Incidence of poor eyesight in Longhua community was lower significantly than in Kangjian community in 2015 covering different grades respectively(P<0.05),the group of primary school contained grade three(3.90% vs 21.30%) and grade five(21.84% vs 34.56%),the group of middle school contained grade seven(6.10% vs 17.71%)and grade nine(10.14% vs 27.78%).[Conclusion] The health service mode has a significant role in promoting eyesight health of primary and middle school students and reducing the poor eyesight incidence.