基层幼儿园学前儿童眼保健服务模式研究及实施效果分析

发布时间：2018-03-31 04:13

本文选题：学前儿童　切入点：眼保健　出处：《中国妇幼保健》2013年14期

【摘要】：目的:探讨基层妇幼保健机构开展幼儿园学前儿童眼保健的必要性和可行性,构建一套基层妇幼保健机构开展学前儿童眼保健的适宜技术,以期能早期发现、早期诊断、早期治疗,以避免视觉损伤的儿童眼病。方法:成立市级儿童眼病筛查中心,指导各区(县)妇幼保健机构对辖区内的幼儿园学前儿童进行眼病筛查,筛查异常者告知监护人带孩子到市级中心儿童眼科复查。建立、健全学前儿童眼病筛查方法和流程,实行标准化管理,并对学前儿童眼病干预实施效果进行分析。结果:3年来,市级中心和9个区(县)中心共筛查217 184名学前儿童,筛查总异常率为8.69%(18 876/217 184)。9个区(县)中心中有5个中心开设了眼保健门诊,开设眼保健门诊的区(县)中心筛查异常率为11.79%(9 538/80 924),与市级中心的筛查异常率(11.99%,4 886/40 753)比较差异无统计学意义(χ2=1.068 2,P=0.301 3)。另外4个尚未开设眼保健门诊的区(县)中心筛查异常率为7.80%(7 452/95 507),与市级中心的筛查异常率比较差异有统计学意义(χ2=608.023 4,P=0.000 0)。有眼保健门诊的区(县)中心与没有门诊的区(县)中心筛查异常率比较差异有统计学意义(χ2=798.893 1,P=0.000)。携复查通知单到市级中心复查的人数逐年增多,复查率逐年提高,3年中共有11 462名儿童到市级中心复查,复查率为60.72%(11 462/18 876)。结论:昆明市对学前儿童眼病的早期干预工作已有成效,需要进一步提高学前儿童眼病筛查覆盖率,特别是农村地区,将儿童眼病筛查工作纳入到新农合范围,在基层妇幼保健机构乃至社区医疗机构推广儿童眼保健适宜技术,提高社区儿童眼保健服务意识和技能,以减少视觉残疾人员的发生率,提高人口素质。
[Abstract]:Objective: to explore the necessity and feasibility of developing preschool children's eye care in primary maternal and child health care institutions, and to construct a set of appropriate technology for pre-school children's eye care in primary maternal and child health care institutions so as to make early detection and early diagnosis.Early treatment to avoid visual injury in children with eye disease.Methods: the city children's eye screening center was set up to guide the district (county) maternal and child health care institutions to screen the preschool children in the district. Those who had abnormal screening told the guardian to take the children to the city center for ophthalmologic reexamination.To establish and perfect the methods and procedures of ophthalmopathy screening for preschool children, to carry out standardized management, and to analyze the effect of intervention in preschool children's ophthalmopathy.Results: in the past three years, 217,184 preschool children were screened in municipal and 9 district (county) centers, and the total abnormal rate of screening was 8.697.18 876 / 217 1844. Eye care clinics were opened in 5 out of 9 district (county) centers.The abnormal rate of screening in the district (county) center of eye care clinic was 11.79% 9 538% 80 924%, which was not significantly different from that of the city level center (蠂 2 1 068 2 P 0. 301 3) compared with that of the city level center (4 886 / 40 753).The abnormal rate of screening in the other 4 district (county) centers without eye care outpatient service was 7.80 / 7 552 / 95,507, which was significantly different from that in the city level (蠂 ~ 2 / 2 = 608.023 / 4 / 0.000).There was significant difference in the abnormal screening rate between the district (county) center with eye care outpatient and the district (county) center without outpatient (蠂 ~ 2 / 798.8931) (蠂 ~ 2 / 798.8931 / P ~ (0.000)).The number of people coming to the city center with the reexamination notice increased year by year, and the reexamination rate increased year by year. In the past three years, 11,462 children came to the city center for reexamination, and the reexamination rate was 60.72% 11 462 / 18 876.Conclusion: the early intervention of preschool children's ophthalmopathy in Kunming City has been successful. It is necessary to further improve the coverage rate of preschool children's ophthalmopathy screening, especially in rural areas, and bring the work of children's ophthalmopathy screening into the scope of NCMS.In order to reduce the incidence of visual disability and improve the quality of the population, the appropriate technology of eye health care should be popularized in the primary maternal and child health care institutions and even in the community medical institutions, and the consciousness and skills of the community children's eye health care service should be improved.
【作者单位】：云南省昆明市妇幼保健院;云南省昆明市妇女儿童保健中心;浙江省温州医学院眼视光医院;
【分类号】：G617;R77

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