老年性白内障手术术前视力调查

发布时间：2018-03-16 08:22

本文选题：白内障　切入点：术前视力　出处：《大连医科大学》2012年硕士论文　论文类型：学位论文

【摘要】：目的：与2000年相比，2010年中国老龄人口从7%增加到8.9%，老龄人口逐渐增加，患老年性白内障的人数也在逐年增加。视力是白内障手术的重要指征之一。中国1999年的百万人口白内障手术率（cataract surgery rate，CSR）是318.3,在2009年CSR达796.2。10年之间白内障手术量增加了近3倍，但是白内障手术术前视力仍多以0.3及以下为主，尤其以防盲为目的的白内障手术严格控制在0.3及以下。本研究的目的是调查过去的十年间沈阳地区老年性白内障手术术前视力变化情况，为防治老年性白内障导致的视力残疾的防治提供流行病学依据及指导性建议。方法：调查沈阳何氏眼科医院2000年第四季度及2010年第四季度所做老年性白内障手术的术前视力情况，共计388眼。根据患者接受手术时间的先后，将同一患者接受双眼白内障手术的，分成第一眼手术和第二眼手术；仅接受一只眼手术的均认为是第一眼手术，其中第一眼手术量316眼，第二眼手术量72眼。2010年第一眼手术量224例，第二眼手术量46例，总计270例。2000年第一眼手术量92例，第二眼手术量26例。总计118例。建立白内障手术患者数据库。手术信息2000年来自沈阳何氏眼科医院手术记录本，2010年来自沈阳何氏眼科医院电子手术记录。其他信息来自何氏眼科医院门诊及住院病案记载。视力分级标准参照国家制定的视力残疾标准主要统计指标：术前矫正视力、年龄、性别。统计分析使用SPS11.5统计软件，在windows系统运行。采用卡方检验、秩和检验和t检验分析，检验水准α=0.05,以P0.05作为差异有统计学意义的标准。结果：1、2010年与2000年相比，第一眼白内障手术，术前视力明显提高（P=0.004）。第二眼白内障手术，术前视力差别无统计学意义（P=0.680）。 2、第一眼术前矫正视力分布2010年与2000年分布明显不同（χ2=11.241，P=0.024），第二眼两年无差别（χ2=3.075，P=0.545）。第一眼术前视力，4级盲下降，从55%降至36%；3级盲及1级低视力增加，3级盲从5%增至13%，1级低视力从18%增至29%；2级低视力和0.3及以上没有变化。 3、2010年第一只眼手术的年龄（69.99±10.153岁）较2000年（66.73±7.877岁）明显增大（t=-3.063，P=0.002）。第二只眼，白内障手术年龄差别无统计学意义（t=0.245, P=0.807）。 4、在第一眼手术时，男性2010年手术年龄（69.70±10.888岁）大于2000年手术年龄（64.80±9.27岁）（t=-2.38，P=0.019）；女性2010年术前平均年龄70.23±9.546岁，2000年67.91±6.701岁，两年间比较差别无统计学意义。（t=-1.651，P=0.1）。在第二眼手术时，男性和女性手术年龄在两年之间差别均无统计学意义（P0.05） 5、2010年与2000年相比，在第一只眼，手术年龄分布有统计学差异（χ2=28.271，P=0.000），在第二眼手术年龄分布差别无统计学意义（P=0.165）。在第一眼，2010年与2000年相比，75岁及以上年龄组手术患者所占比例明显增加，65-74岁年龄组手术患者所占比例明显下降，45-64岁年龄组变化不明显。 6、第一只眼和第二只眼白内障手术，男女术前视力比较均无明显差别。 7、第一只眼和第二只眼白内障手术，术前视力与年龄均无关。 8、第一只眼白内障手术，术前视力与合并眼病有关（χ2=10.920，，P=0.027）；在第二只眼，术前视力与合并眼病无关（χ2=8.958，P=0.062）。结论：2010年与2000年相比，白内障手术术前视力水平提高，并且术前4级盲明显减少，3级盲增加，1级低视力增加，2级低视力、0.3及以上变化不明显。白内障盲大大减少。有更多的老年人（年龄在75岁以上）接受白内障手术，更多视力损伤较轻的人接受手术。与此同时，手术患者平均年龄增加。视力受合并眼部其它影响视力的疾病影响，与年龄、性别无关。
[Abstract]:Objective: compared with 2000, 2010 China aging population increased from 7% to 8.9%, the aging population gradually increased and the number of people suffering from senile cataract is increasing year by year. Visual cataract surgery is an important indication of cataract surgery in 1999. Millions of people Chinese rate (cataract surgery rate, CSR) is 318.3, up to the amount of cataract surgery between 796.2.10 to CSR in 2009 increased by nearly 3 times, but the cataract surgery preoperative visual acuity is 0.3 and below, especially in the prevention of cataract surgery for the purpose of strict control in 0.3 and below. The purpose of this study is to investigate the past ten years in Shenyang area of senile cataract surgery preoperative visual acuity, provide epidemiological basis and guidance for the prevention and treatment of senile cataract resulting in visual disability prevention.
Methods: the visual acuity survey in Shenyang He Eye Hospital in 2000 fourth quarter and the fourth quarter of 2010 the senile cataract surgery before the operation, a total of 388 eyes of patients underwent surgery. According to the time sequence of the same patient underwent bilateral cataract surgery, divided into the first eye surgery and second eyes received only one eye surgery operation; are believed to be the first eye operation, wherein the first eye surgery in 316 eyes, second eyes and 72 eyes in the first surgery.2010 eye surgery 224 cases, second eyes surgery in 46 cases, a total of 270 cases of the first year.2000 eye surgery in 92 cases, second eyes surgery in 26 cases. A total of 118 cases.
A database of cataract surgery patients was established. Operative information was collected from the surgical records of Ho's eye hospital in Shenyang in 2000, and electronic surgery records from Ho's Eye Hospital of Shenyang in 2010. Other information is from the outpatient and inpatient records of Ho's ophthalmology hospital.
Vision classification standards refer to the national standard of visual disability
Main statistical indicators: preoperative correction of visual acuity, age, and sex.
Statistical analysis was carried out in the windows system using SPS11.5 statistical software. Chi square test, rank sum test and t test were used to test the level of alpha =0.05, and P0.05 was used as a standard with statistically significant difference.
Results: in 12010 years compared with 2000, the first cataract surgery had significantly improved visual acuity before operation (P=0.004). There was no significant difference in visual acuity between second eyes before cataract surgery (P=0.680).
2. The distribution of corrected visual acuity in the first eye was significantly different between 2010 and 2000
(x 2=11.241, P=0.024), there was no difference between the second eyes (chi 2=3.075, P=0.545). The first eye visual acuity, the 4 grade blindness decreased from 55% to 36%, the 3 grade blindness and 1 grade low vision increased, 3 grade blind 5% increased to 13%, 1 grade low vision increased from 18% to 18%, and there was no change in the low grade vision and above or above.
In 32010 years, the age of operation in the first eye (69.99 + 10.153 years) increased significantly compared with that in 2000 (66.73 + 7.877 years). There was no significant difference in the age of cataract between second eyes (t=-3.063, P=0.002) (t=0.245, P=0.807).
4, in the first eye surgery, male 2010 operation age (69.70 + 10.888) than the 2000 operation age (64.80 + 9.27 years) (t=-2.38, P=0.019); 2010 women preoperative mean age 70.23 + 9.546, 67.91 + 6.701 years in 2000, two years there was no significant difference (t=-1.651, P=0.1). In second eye surgery, male and female operation at the age of two years between the difference was not statistically significant (P0.05)
52010 compared with 2000, in the first eye, there were significant differences in operative age distribution (x 2=28.271, P=0.000), there was no significant difference in the age distribution of the second eye surgery (P=0.165). At first glance, in 2010 compared with 2000, patients aged 75 years and above age group the proportion increased significantly, 65-74 year old age group the proportion of patients decreased significantly, 45-64 year old age group did not change significantly.
6, first eye and second eye cataract surgery, there was no significant difference in visual acuity between men and women before operation.
7, first eye and second eye cataract surgery, preoperative vision was not related to age.
8, in the first cataract surgery, preoperative visual acuity was associated with eye disease (chi 2=10.920, P=0.027). In second eyes, preoperative visual acuity was not associated with eye disease (chi 2=8.958, P=0.062).
Conclusion: 2010 compared with 2000, cataract surgery preoperative visual acuity improved, and preoperative grade 4 blind was significantly reduced, 3 blind increase, 1 low vision increased, 2 low vision, 0.3 and above did not change significantly. Cataract blindness greatly reduced. There are more elderly people (aged over 75) accept cataract surgery, more visual acuity less injury who underwent surgery. At the same time, the average age of patients increased. Visual acuity was associated with eye disease affecting the visual effect of the other, with age and gender.

【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R779.6

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