环境因素预防及管理儿童青少年近视的最佳证据总结

A summary of the best evidence on environmental factors to prevent and manage myopia in children and adolescents

目的全面检索、分析并整合环境因素预防及管理儿童青少年近视的最佳证据,为制订科学完整的近视预防及管理方案提供参考。方法系统检索UpToDate、BMJ Best Practice、Cochrane Library、JBI循证卫生保健中心数据库、中华医学知识库、中华中医药学会、中华医学会、美国眼科学会、国际近视学会、欧洲眼科学会、国际防盲机构、Brien Holden视觉研究中心、PubMed、Web of Science、Embase、中国知网、万方等关于环境因素预防及管理儿童青少年近视的指南、专家共识、系统评价/Meta分析、证据总结、最佳临床实践,对其进行质量评价,并结合专业判断提取和汇总证据。结果共纳入23篇文献,包括指南6篇、专家共识3篇和系统评价14篇。从预防及管理目的、风险评估、环境预防及管理措施和健康教育4个方面总结了27条最佳证据。结论该研究总结了环境因素预防及管理儿童青少年近视的最佳证据,在证据应用时,应根据实际情况,选择合适的环境预防及管理措施,预防和控制儿童青少年近视的发生和发展,促进循证实践。

Objective To comprehensively search,analyze and integrate the best evidence on environmental factors for the prevention and management of myopia in children and adolescents,to provide reference for the formulation of scientific and complete myopia prevention and management programs.Methods A comprehensive search about evidence on environmental factors prevention and management of myopia in children and adolescents was conducted in following databases:UpToDate,BMJ Best Practice,Cochrane Library,JBI Evidence-Based Health Care Center Database,Chinese Medical Ace Base,China Association of Chinese Medicine,Chinese Medical Association,American Academy of Ophthalmology,International Myopia Society,European Society of Ophthalmology,International Agency for the Prevention of Blindness,Brien Holden Vision Research Center,PubMed,Web of Science,Embase,China National Knowledge Infrastructure,Wanfang,etc.Research types included guidelines,expert consensus,systematic review/Meta-analysis,evidence summary,best clinical practice.Results A total of 23 articles were included,including 6 guidelines,3 expert consensus articles and 14 systematic reviews.Evidence summarized 27 items from the following 4 aspects:prevention and management purpose,risk assessment,environmental prevention and management measures and health education.Conclusions This study summarized the best evidence on environmental factors to prevent and manage myopia in children and adolescents.When the evidence is applied,appropriate environmental prevention and management measures should be selected to prevent and control the onset and progression of myopia in children and adolescents,based on the actual situation,to promote evidence-based practice.