0~3岁儿童屈光筛查及屈光不正相关影响因素分析

Analysis of influencing factors of refractive screening and ametropia in 0-3 years old children

目的了解0~3岁儿童屈光发育状况及影响因素,为儿童眼保健提供参考依据。方法选取2020年8月至2021年7月在该院儿保门诊进行健康体检的6个月至3岁儿童2914名,采用非散瞳视网膜检影法进行屈光筛查,同时发放自制问卷调查表1240张,并对结果进行分析,从而找出屈光不正的相关影响因素。按不同年龄分为6个月至1岁组(810名)、>1~2岁组(878名)、>2~3岁组(1226名)。结果2914名儿童屈光异常率为21.52%(627/2914),其中男296名,屈光异常率为47.21%;女331名,屈光异常率为52.79%;女童屈光异常率较男童略高,但差异无统计学意义(P>0.05);6个月至1岁组儿童屈光异常率为32.47%(263/810),>1~2岁组儿童屈光异常率为18.11%(159/878),>2~3岁岁组儿童屈光异常率为16.72%(205/1226)。随着年龄的增长屈光异常率有下降趋势,差异有统计学意义(P<0.05)。儿童屈光异常与居住地、母亲孕期患病史、眼疾家族史(父母任一方高度近视或散光)、开灯睡觉、儿童入睡时间、睡眠时间、挑食、接触电子产品年龄、近距离用眼时间、户外时间、不良用眼姿势、揉眼等相关,差异均有统计学意义(P<0.05);与父母文化程度、儿童出生史(早产、出生低体重)无关,差异均无统计学意义(P>0.05)。结论0~3岁儿童屈光异常率较高,与家族遗传、儿童不良用眼及生活习惯相关。在眼保健门诊中应该重视眼保健知识的宣教,加强对相关因素的干预。

Objective To investigate the refractive development status of children aged 0-3years old and its influencing factors,so as to provide evidence for eye care in children.Methods A total of 2914children aged six months to three years who underwent physical examination in the child care clinic of the hospital from August 2020to July 2021were randomly selected.Non-dilated retinal examination was used for refractive screening.At the same time,1240self-made questionnaires were issued,and the results were analyzed to find out the related influencing factors of ametropia.According to different ages,the children were divided into the 6-month-old to 1-year-old group(n=810),the>1-year-old group(n=878)and the>2-year-old group(n=1226).Results The rate of abnormal refraction of 2914children was 21.52%(627/2914),including296males(47.21%)and 331females(52.79%).The rate of abnormal refraction of girls was slightly higher than that of boys,but the difference was not statistically significant(P>0.05).The rate of abnormal refraction was 32.47% in the 6-month-old group(263/810),18.11% in the 1-year-old group(159/878),and16.72% in the 2-3-year-old group(205/1226).With the increase of age,the rate of abnormal refraction showed a downward trend,and the difference was statistically significant(P<0.05).The place of residence,mother pregnancy disease history,family history of eye disease(parents either high myopia or astigmatism),sleep with the light on,time to fall asleep,sleep duration,fussy,contact electronics age,close eye time,outdoor time,bad posture when using eyes,rubbing eyes had correlation with children′s ametropia,the differences were statistically significant(P<0.05).There were no significant differences in parents′education level and children′s birth history(preterm birth and low birth weight)(P>0.05).Conclusion The rate of abnormal refraction in children aged 0-3years is high,which is related to family heredity and children′s poor eye use and living habits.In the eye care clinic,attention should be paid to the education of eye care knowledge and the intervention of related factors should be strengthened.