刘佳 濮清岚 周巧云 李勇 许维馨

[摘要] 目的 了解嘉興市南湖区3周岁学龄前儿童的屈光不正的患病率及分析其相关危险因素。 方法 采用美国伟伦公司的Suresight手持式筛查仪对2019年7—9月在我院行入幼体检的5609名3周岁儿童，进行双眼屈光状态检查。通过采用自行设计的调查表，从性别、出生方式、出生体重、有无早产，是否存在屈光异常家族史及用眼情况等方面进行相关因素分析。 结果 3周岁学龄前儿童屈光不正率为10.2%，其中其中远视39.12%（205/524）、散光58.77%（308/524）、近视2.10%（11/524），散光为3周岁年龄段儿童主要的屈光异常类型。屈光不正单因素分析3周岁学龄前儿童屈光不正患病率与父母有吸烟史、早产、低体质量新生儿、每天户外活动<2 h，平均使用电子产品时间>2 h/D有关（P<0.05）。将以上因素纳入非条件Logistic回归模型，结果显示，父母有吸烟史、早产、低体质量儿、户外活动时间≤2 h/d、平均电子产品使用时间≥2 h/d是3周岁学龄前儿童屈光异常的危险因素（P<0.05）。结论 嘉兴市南湖区3周岁学龄前儿童的主要屈光不正类型为散光。父母有吸烟史、早产、低体质量儿童、户外活动时间少、长时间近距离用眼是儿童屈光异常的独立危险因素。

[关键词] 学龄前儿童;屈光不正;影响因素;Suresight 视力筛查仪

[中图分类号] R779.7          [文献标识码] B          [文章编号] 1673-9701（2021）33-0158-04

[Abstract] Objective To understand the prevalence of refractive errors in 3-year-old preschool children in Nanhu District of Jiaxing City and analyze its related risk factors. Methods The Suresight hand-held screener from Weilun Company of the United States was used to examine the refractive status of 5609 3-year-old children who underwent larval physical examination in our hospital from July to September 2019. Through the use of self-designed questionnaires， relevant factors were analyzed in terms of gender， birth method， birth weight， premature birth， family history of refractive abnormalities， and eye use. Results The refractive error rate of 3-year-old preschool children was 10.2%. Among them， hyperopia 39.12%（205/524）， astigmatism 58.77%（308/524）， myopia 2.10%（11/524）， astigmatism were the main types of refractive abnormality in children at the age of 3 years. Single-factor analysis of refractive error showed that the prevalence of refractive error in 3-year-old preschool children was related to parents' smoking history， premature birth， low-weight newborns， daily outdoor activities <2 h， and average use of electronic products>2 h/D（P<0.05）. The above factors were incorporated into the unconditional logistic regression model， and the results showed that parents with a history of smoking， premature birth， low-weight infants， outdoor activity time ≤2 h/d， average electronic product use time ≥2 h/d were the risk factors for 3-year-old preschool children with refractive error （P<0.05）. Conclusion The main type of refractive error in 3-year-old preschool children in Nanhu District of Jiaxing City is astigmatism. Parents with a history of smoking， premature birth， low-weight children， less time outdoors， and long-term use of eyes at close range are independent risk factors for children's refractive abnormalities.

[Key words] Preschool children; Refractive error; Influencing factors; Suresight vision screener

屈光不正是造成儿童期视力损害的最常见的原因[1]。其中严重的散光，远视和屈光参差可引起儿童弱视。视觉功能从出生起就在外界刺激中不断的发育和成熟，通常3～6岁是儿童视觉功能发育的关键时期，此阶段内任何异常刺激都可能对儿童视觉产生不良影响[2]。在这一时期内除去影响视力的不良因素，可使大部分弱视得到治愈，对儿童视觉发育起到关键作用。屈光筛查是儿童眼保健的重要内容，可以了解学龄前儿童群体的屈光状态，及时发现超出生理范围可能影响视力的屈光异常，早期诊断和治疗弱视，本研究对5609例3周岁入幼体检的儿童进行屈光筛查，研究此年龄段儿童屈光异常的患病率，及各种类型屈光异常的分布特点，探讨影响学龄前儿童屈光不正的危险因素。……