2017年湖南省中小学生视力不良现况及环境影响因素分析

Prevalence and environmental influencing factors of poor eyesight among primary and middle school students in Hunan province, 2017

目的了解湖南省中小学生视力不良分布状况及影响因素,为政府制定防治策略提供科学依据。方法于2017年抽取湖南省8 129名小学四年级到高中三年级学生进行体检和问卷调查,采用适当的统计方法对数据进行分析。结果2017年湖南省中小学生总体视力不良率为64.9%,有随教育阶段(小学44.4%,初中73.2%,高中78.8%)升高的趋势(χ趋势^2=702.732,P<0.001);轻度、中度、重度视力不良率分别为6.6%,19.9%和38.5%,其中轻度视力不良率(小学8.1%,初中6.8%,高中4.6%)随教育阶段升高而减少(χ趋势^2=25.452,P<0.001),重度视力不良率(小学17.0%、初中44.2%、高中56.3%)随教育阶段升高而升高(χ趋势^2=870.331,P<0.001);各教育阶段学生轻度、中度、重度视力不良构成比差异有统计学意义(χ^2=365.232,P<0.001),随教育阶段升高,轻度、中度视力不良构成比下降,重度视力不良构成比上升。城区中小学生视力不良率高于县城(χ^2=10.013,P=0.002),女生高于男生(χ^2=86.021,P<0.001),城区和县城女生分别高于城区和县城男生(χ^2=29.891及63.352,P<0.001),城市男生高于乡镇男生(χ^2=17.228,P<0.001)。中小学生视力不良环境影响因素中,平均每天户外活动时间超过2 h(OR=0.725,95%CI:0.661~0.796)及监护人和老师经常提醒读写姿势(OR=0.793,95%CI:0.720~0.873)为保护因素,平均每天写作业超过2 h(OR=1.520,95%CI:1.383~1.67)及平均每天使用电子设备上网超过2 h(OR=1.358,95%CI:1.224~1.507)为危险因素。结论2017年湖南省中小学生视力不良率及重度视力不良率均较高,且随教育阶段升高。城市为重点地区,女生为重点人群。应采取措施减少中小学生写作业时间及使用电子设备时间,监护人及老师应及时提醒学生保持正确读写姿势和增加户外活动。

Objective To investigate the distribution status and influencing factors of poor vision among primary and middle school students in Hunan province so as to provide a scientific basis for government departments to develop preventive strategies. Methods Physical examination and questionnaire surveys were conducted among 8,129 students selected from Grades 4-6 in primary schools and Grades 7-12 in middle schools in Hunan province in 2017, and the data were analyzed by appropriate statistical methods. Results The overall prevalence rate of poor vision in primary and middle school students in Hunan province in 2017 was 64.9%. The prevalence rates of poor vision in primary schools, junior middle schools and senior middle schools were 44.4%, 73.2% and 78.8% respectively, showing an increasing trend with the increment of education period(χtendency2=702.732, P<0.001). The prevalence rates of slight, moderate and severe poor vision were 6.6%, 19.9% and 38.5% respectively. The prevalence rates of slight poor vision in primary schools(8.1%), junior middle schools(6.8%) and senior middle schools(4.6%) showed a decreasing trend with the increment of education period(χtendency2=25.452, P<0.001), while the prevalence rates of severe poor vision in primary schools(17.0%), junior middle schools(44.2%) and senior middle schools(56.3%) demonstrated an upward trend with the increment of education period(χtendency2=870.331, P<0.001). There were statistically significant differences in the proportions of slight, moderate and severe poor vision among pupils, junior and senior middle schools(χ^2=365.232, P<0.001). The proportions of slight and moderate poor vision decreased with the increment of education period, but that of severe poor vision increased. The prevalence rate of poor vision was higher in urban primary and middle school students than in rural ones(χ^2=10.013, P=0.002), higher in girls than in boys(χ^2=86.021, P<0.001), higher in urban girls than in urban boys(χ^2=29.891, P<0.001), higher in rural girls than in rural boys(χ^2=63.352, P<0.001), and higher in urban boys than in rural ones(χ^2=17.228, P<0.001). Among the environmental factors influencing poor vision in primary and middle school students, spending more than 2 hours for outdoor activities per day(OR=0.725, 95%CI: 0.661-0.796) and being restrained to keep correct reading and writing gesture by guardians and teachers(OR=0.793, 95%CI: 0.720-0.873) were protective factors, while spending more than 2 hours for homework per day(OR=1.520, 95%CI:1.383-1.67) and spending more than 2 hours for surfing the Internet by electronic devices(OR=1.358, 95%CI:1.224-1.507) were risk factors. Conclusions The prevalence rates of poor vision and severe poor vision in primary and middle school students in Hunan province in 2017 were high, and showed an increasing trend with the increment of education period. Special attention should be paid to urban areas and female students. Measures for reducing homework and the use of electronic devices should be adopted;moreover, guardians and teachers should timely remind students to keep correct reading and writing gesture and increase outdoor activities.