军事飞行员干眼影响因素分析及“治未病”防治

Causes and prevention of xerophthalmia in military pilots

目的了解军事飞行员的干眼现状,分析其影响因素。方法选取2021年3月—2023年1月在联勤保障部队第九八八医院就诊的660名军事飞行员作为研究对象,进行一般情况调查问卷、眼表疾病指数量表(Ocular Surface Disease Index,OSDI)调查和眼科专科检查,采用χ2检验对军事飞行员干眼发生因素进行分析,差异有统计学意义的干眼发生因素纳入二元Logistic回归分析。结果OSDI调查结果显示,45.45%(300/660)飞行员存在干眼体征,其中轻度干眼体征占81.67%(245/300)、中度干眼体征占10.00%(30/300)、重度干眼体征占8.33%(25/300);根据干眼的诊断标准,确诊为干眼的飞行员占8.94%(59/660);Logistic回归结果显示,年龄41~50岁(OR=3.089,P=0.010),总飞行时间>1500~2500 h(OR=6.352,P=0.003)、>2500~3500 h(OR=4.626,P=0.010)、>3500~5000 h(OR=9.210,P<0.001)、>5000 h以上(OR=26.577,P=0.001),飞行中经常口干(OR=5.924,P=0.032),每日使用视频显示终端时间>4 h(OR=4.631,P=0.005)是导致干眼的危险因素,而观看视频显示终端1 h休息眼睛(OR=0.143,P<0.001)是保护因素。结论军事飞行员干眼患病率较高,建议根据飞行员工作和生活特殊性,加强干眼疾病的管理和教育,预防干眼的发生和发展。

Objective To find out about the current incidence of xerophthalmia in military pilots and analyze the causes.Methods A total of 660 military pilots who sought treatment at the 988th Hospital of the Logistic Support Force between March 2021 and January 2023 were selected as the subjects.A survey involving questionnaires about basic information,Ocular Surface Disease Index(OSDI)surveys,and ophthalmological examinations were conducted.Chi-square tests were used to analyze the factors contributing to xerophthalmia in military pilots,and factors with statistically significant differences were analyzed using binary logistic regression analysis.Results The results of OSDI showed that 45.45%(300/660)of the pilots had signs of dry eyes,including mild dry eye signs(81.67%,245/300),moderate dry eye signs(10.00%,30/300)and severe dry eye signs(8.33%,25/300).Based on diagnostic criteria for xerophthalmia,pilots diagnosed with xerophthalmia accounted for 8.94%(59/660).Logistic regression showed that the age ranged from 41 to 50 years(OR=3.089,P=0.010).Total flight time:>1500~2500 h(OR=6.352,P=0.003),>2500~3500 h(OR=4.626,P=0.010),>3500~5000 h(OR=9.210,P<0.001),>5000 h or more(OR=26.577,P=0.001).Frequent dry mouth during flight(OR=5.924,P=0.032),daily use of video display terminal>4 h(OR=4.631,P=0.005)were the risk factors for dry eyes.And watching video display terminal>1 h without resting eyes(OR=0.143,P<0.001)was the protective factor for dry eyes.Conclusion The prevalence of xerophthalmia among military pilots is relatively high,suggesting the need to exercise more effective control over xerophthalmia as required by pilots in order to prevent the occurrence and progression of xerophthalmia.