目的:分析上海奉贤东部地区白内障复明手术现状及手术覆盖率,探讨其影响复明手术的相关因素及发展趋势。在"新农合"(新型农村合作医疗)政策下提高白内障手术率及质量,加速白内障防盲工作的进展。方法:收集回顾2008-01/2010-08间55岁以上白内障复明手术患者资料,以我国目前白内障流行病学调查的标准及世界卫生组织(WHO)盲与低视力的诊断标准对手术结果进行评估,统计性别、年龄构成、手术效果、医疗保障构成及术后低视力的原因,分析新农合政策下,对白内障复明手术的影响。结果:白内障手术患者994例1260眼中,女649例806眼,男345例454眼,女性患者多于男性患者,年龄55～99(平均74.75±7.92)岁。5个年龄组中70～79岁年龄组515例,最多,占51.81%。术后矫正视力≥0.05白内障患者1242眼,脱盲率为98.57%;术后矫正视力≥0.3白内障患者1179眼,脱残率为93.57%;人工晶状体植入1241眼,晶状体植入率98.49%;1260眼手术后,共39眼出现手术后并发症,占总手术眼的3.10%。在白内障手术患者的保障构成方面,农保561例,占手术人数56.44%,镇保135例,占手术人数13.58%,两项合计占复明手术人数的70.02%。结论:白内障仍是高龄者的致盲眼病,女性手术率高于男性;在新型农村合作医疗制度下,上海奉贤东部地区老年白内障手术率较高,白内障术后脱盲率、脱残率及晶状体植入率亦较高。老年人防盲和改善低视力工作的关键是白内障眼疾的早期诊断和治疗,防治白内障仍是防盲治盲工作的重点。

AIM:To investigate the related factors and trends of cataract operation by analysing the current situation of operation and surgical rate in eastern Fengxian community of Shanghai and to improve cataract surgical rate and quality and to accelerate the work progress of cataract prevention of blindness under the policy of new type of rural cooperative medical care system(NCMS)·METHODS: Data of over 55 years old patients who had accepted cataract surgery between January 2008 and August 2010 were collected and then evaluated with standard of our current cataract epidemiological survey and diagnostic criteria of World Health Organization(WHO) to blind or low vision;Gender,age,effect of surgery,health care and the causes of postoperative low vision,and the effect of policy of "NCMS"on cataract operation were statistically analyzed·RESULTS:Among 994 patients(1260 eyes),649 female(806 eyes) and 345 male(454 eyes),the number of female patients were much more than that of the male,the minimal age was 55,maximal 99 and average 74.75±7.92 years old.The age group of 70-79,including 515 patients,accounted for 51.81% of all patients.The number of patients whose postoperative corrected visual acuity was greater than or equal to 0.05 was 1241 eyes,off-blindness rate was 98.6%;greater than or equal to 0.3 was 1179 eyes,off-disability rate was 93.57%;the IOL implantation rate was 98.49%.39 eyes occurred complications,accounting for 3.10% of all patients.In the aspect of health care composition of cataract surgery patients,farm security had 561 people accounting for 56.44%;town security had 135 people accounting for 13.58%;the summation of these two items took up 70.02% of all patients·CONCLUSION: Cataract is the main cause of blindness among the elder.The morbidity of female is much higher than that of male.Under the institution of NCMS,the cataract surgical rate of Eastern Fengxian community of Shanghai is high,and so do the off-blindness rate,off-disability rate and IOL implantation rate postoperatively.Preventing blindness and improving low vision is focused on early diagnosis and treatment of cataract.Cataract is still the key of blindness prevention work.

R779.66