新疆喀什地区脑瘫儿童青少年视觉障碍特征分析

Characteristics of Visual Impairment in Children and Adolescents with Cerebral Palsy in Kashgar,Xinjiang

目的:首次全面精准分析新疆喀什地区脑瘫儿童青少年的视觉障碍特征和治疗情况,促进其视觉康复和全身康复的早期开展。方法:横断面调查研究。选取2018年10月于新疆维吾尔自治区喀什地区某综合医院集中行眼部筛查的脑瘫儿童青少年,对其进行眼科检查,包括屈光状态、眼位、眼前节和眼底检查,并调查其眼科治疗情况。采用卡方检验对数据进行分析。结果:纳入176例脑瘫儿童青少年,年龄0.8~12(6.4±2.7)岁,其中0.8~6岁有97例(55.1%),维吾尔族169例(96.0%),男性104例(59.1%)。存在视觉障碍人数105例(59.7%),3例(1.7%)同时伴有2种视觉障碍,视觉障碍的发生率为108例(61.7%),包括屈光不正(48例,27.3%)、斜视(43例,24.4%)和其他眼部疾病(17例,9.7%)。所有脑瘫儿童青少年屈光不正以远视为主(20例,11.4%),斜视以外斜视最常见(25例,14.2%),占比最高的前3种其他眼部疾病是视神经萎缩、先天性白内障和先天性青光眼,均为4例(2.3%)。仅27例(15.3%)脑瘫儿童青少年以往接受过眼科检查,剩余149例(84.7%)均为第1次接受眼科检查;105例视觉障碍者中仅6例(5.7%)以往接受过眼科检查。所有脑瘫儿童青少年近视发生率为9.7%(17例),不同性别、年龄段、民族以及是否斜视之间近视的发生率差异没有统计学意义。结论:脑瘫儿童青少年视觉障碍发生率高于同年龄段儿童,且斜视发生率非常高。这也提示在脑瘫儿童青少年中普及眼健康筛查的迫切性和重要性,可作为今后开展脑瘫患者康复工作的重点内容之一。

Objective:For the first time to accurately and comprehensively analyze the characteristics and treatment of visual impairment children and adolescents with cerebral palsy in Kashgar,Xinjiang,to promote their early development of visual and general rehabilitation.Methods:This cross-sectional study selected children and adolescents with cerebral palsy who underwent eye screening in a general hospital in Kashgar,Xinjiang,Uygur Autonomous Region,in October 2018.Ophthalmic examinations were conducted,including refractive error,eye position,anterior segment and fundus examination.Their ophthalmic treatment history was also investigated.The data were analyzed by chi square tests.Results:One hundred seventysix children and adolescents with cerebral palsy were enrolled.The average age was 6.4±2.7 years(0.8-12 years),of which 97 cases(55.1%)were between 0.8 to 6 years old,169 were Uighurs(96.0%)and 104 were males(59.1%).There were 105 cases(59.7%)with visual impairment,of which 3 cases(1.7%)were accompanied by two simultaneous visual disorders.The incidence of visual impairment was 61.7%(108 cases)that manifested as ametropia(48 cases,27.3%),strabismus(43 cases,24.4%)and other eye diseases(17 cases,9.7%).Hyperopia(20 cases,11.4%)was most common in ametropia,exotropia(25 cases,14.2%)was most common in strabismus,and optic nerve atrophy,congenital glaucoma and congenital cataract(4 cases each,2.3%)were the most common among other eye diseases.Only 27 cases(15.3%)received previous ophthalmic examinations,the remaining 149 cases(84.7%)were undergoing ophthalmic examinations for the first time,and only 6 of 105 cases(5.7%)with visual impairment had received ophthalmic examinations before.The incidence of myopia in all children and adolescents with cerebral palsy was 9.7%(17 cases).There was no significant difference in the incidence of myopia between children and adolescents with cerebral palsy when gender,age group,nationality and strabismus were taken into account.Conclusion:The incidence of visual impairment in children and adolescents with cerebral palsy is higher than that in normal children of the same age,and the incidence of strabismus is very high.However,the rate of children receiving ophthalmic examinations was low,it may due to their parents are not well aware of accompanying ophthalmic diseases.It suggests the urgency and importantance to popularize eye health screening in cerebral palsy children and adolescents.