目的:调查温州市防盲治盲的情况,并作数据分析,探讨适合当前农村实际情况的防盲治盲方法。方法:采取随机整体抽样方法,派出医疗队建立长效病员筛查机制,定期组织医疗队下乡进行筛查,采用统一设计的检查流程表,用标准对数视力表和小孔镜检查视力,进口的便携式裂隙灯和手持式眼底镜检查眼部情况。接需要手术的病员到医院接受小切口非超声乳化白内障摘除联合人工晶状体植入术治疗,保证免费复明手术的高质量。对眼病患病率和年龄、性别进行统计学分析,并抽样调查进行流行病学分析。结果:共组织医护人员下乡开展白内障筛查201批次,普查覆盖了全市200多个乡镇,共筛查23020例。检查出影响老年人视力及视觉质量的眼疾患者12786例,主要有白内障、翼状胬肉、屈光不正,其余为角膜病变、眼底病变、青光眼、斜弱视、葡萄膜炎和眼肿瘤及眼眶病。白内障患病率随年龄而增高,女性总患病率高于男性,具有统计学意义(P=0.005)。其中符合手术条件的白内障患者6869例,目前在此基础利用各种防盲治盲资源已成功实施免费白内障手术5011例。抽样调查显示脱盲率99.2%,脱残率95.0%,术后视力恢复情况良好。结论:通过全市农村的眼病流行病学调查,了解我市致盲原因及分布情况,为我市进一步开展防盲治盲工作指出了重点和方向。开展定期医疗队下乡筛查和接病员到医院实施小切口白内障手术是适合经济欠发达地区可推广的防盲模式之一。

AIM:To investigate the situation of prevention and treatment for blindness,analyze the data and find a suitable way for prevention and treatment for blindness in rural area.METHODS:We used the random sampling method,sent the medical team to establish the long-lasting patients sifting mechanism,the medical team could organize the regular visit to the rural area,the same version checking flow sheet,standard logarithmic visual acuity chart and stenopaic spectacles were used to check the visual acuity,the imported portable slit-lamp and handheld ophthalmoscope were used to check the bottom of the eyes.In order to ensure the high quality of vision rehabilitation surgery,those who needed the operation had to accept the small incision non-phacoemulsification cataract extraction and intraocular lens implantation.The patients’ ages,gender were analyzed with statistically and samples were taken for epidemic analysis.RESULTS:We had visited the rural area for 201 times,it covered more than 200 towns,totally 23020 people had the examination,the major facts affecting the older people’s vision quality were cataract,pterygium,ametropia,and others,such as thygeson,retinopathy,glaucoma,strabismus,amblyopia,uveitis,eye tumor and orbital disease.The cataract prevalence rate was growing with age,the female had higher rate than male,it was statistically significant(P=0.005).There were 6869 people that could be applied the cataract extraction surgery,of which 5011 people had already done it.The sampling survey showed the visual rehabilitation rate was 99.2% and the disability recovery rate ws 95.0%,most patients could recover soon.CONCLUSION:The investigation of the epidemiology of rural area in Wenzhou provides us the reasons and distribution of blindness and shows us the direction of blindness prevention and treatment.Regular sifting mechanism in rural area of selecting and sending patients to have the small incision non-phacoemulsification cataract extraction is an acceptable mode in those undeveloped areas.

R77

中国国家自然科学基金重点资助项目(No.60827002)