發(fā)布時(shí)間：2018-06-06 16:59

  本文選題：白內(nèi)障 + 患病率�。� 參考：《山東大學(xué)》2013年碩士論文

【摘要】：背景我國是全世界3個(gè)盲人高發(fā)地區(qū)之一,約有盲人近700萬,占世界盲人總數(shù)的18%。其中,有50%是由于白內(nèi)障所致。手術(shù)治療被公認(rèn)是根治白內(nèi)障最有效的方法,提高手術(shù)數(shù)量并保證手術(shù)質(zhì)量是消除白內(nèi)障引起的盲和視力損傷的重點(diǎn)所在。目前,白內(nèi)障發(fā)病機(jī)制尚不明確,我國白內(nèi)障手術(shù)服務(wù)利用情況也鮮有研究。本研究主要從社會(huì)醫(yī)學(xué)研究角度出發(fā),探索白內(nèi)障相關(guān)因素,并分析白內(nèi)障手術(shù)服務(wù)利用情況及障礙因素,為白內(nèi)障防制策略制定提供依據(jù)。 目的了解山東省滕州市50歲及以上居民白內(nèi)障患病率、白內(nèi)障手術(shù)率及手術(shù)覆蓋率,并分析其影響因素。 方法將滕州市所有行政村、居委會(huì)劃分為基本抽樣單位(BSU),隨機(jī)整群抽取27個(gè)調(diào)查點(diǎn),對調(diào)查點(diǎn)50歲及以上人群進(jìn)行眼部檢查及問卷調(diào)查�，F(xiàn)場檢查與調(diào)查于2008年4-7月間進(jìn)行,其前先對居民進(jìn)行檢錄。視力檢查采用標(biāo)準(zhǔn)對數(shù)視力表。以協(xié)和醫(yī)院趙家良教授開展的全國眼科流行病學(xué)調(diào)查采用的界定標(biāo)準(zhǔn)計(jì)算白內(nèi)障患病率、手術(shù)率及手術(shù)覆蓋率。正式調(diào)研前進(jìn)行了預(yù)試驗(yàn)。整個(gè)研究從調(diào)查前、現(xiàn)場調(diào)查階段和調(diào)查后三個(gè)環(huán)節(jié)分別采取了相關(guān)措施以保證研究質(zhì)量。 結(jié)果本研究共檢錄50歲及以上居民5557人,實(shí)際受檢4916人,應(yīng)答率為88.46%。(1)受檢4916人,白內(nèi)障患者1308人,患病率為26.6%。單因素分析結(jié)果顯示：女性患病率29.8%,男性患病率為22.6%(P=0.000)；50-59歲組患病率為6.6%,60-69歲組患病率為27.1%,70-79歲組患病率為58.1%,80歲及以上組患病率78.5%(P=0.000)；文盲組患病率為33.4%,小學(xué)以下組患病率為15.6%,小學(xué)組患病率為14.4%,初中及以上組患病率為12.1%(P=0.000)；在婚者患病率為21.1%,獨(dú)身者患病率為53.3%(P=0.000)；人均年收入0-元組患病率為50.6%,1000-元組為28.8%,3000-元組為19.4%,5000-元組為14.6%(P=0.000)；低保戶居民患病率為48.3%,非低保戶居民患病率為25.8%(P=0.000)；自評健康好、中、差者患病率依次為19.5%、31.2%、42.8%(P=0.000)；親屬中有盲與低視力者患病率為34.0%,無者患病率為26.1%(P=0.002)；不吸煙者患病率為24.4%,吸煙者患病率為27.3%,以前吸現(xiàn)已戒者患病率為33.5%(P=0.004)；從不飲酒者患病率為17.3%,偶爾飲者患病率為24.2%,經(jīng)常飲者患病率為29.4%,以前喝現(xiàn)已戒者患病率為27.0%(P=0.000)；口味偏淡、中等、偏咸者患病率依次為24.2%、27.6%、31.4%(P=0.000)。多因素分析結(jié)果顯示,性別、年齡、婚姻狀況、受教育程度、人均年收入、自評健康、親屬有無盲及低視力及飲酒狀況等因素是白內(nèi)障患病的危險(xiǎn)因素。(2)受檢4916人中,接受白內(nèi)障手術(shù)患者為65人,手術(shù)率為1.3%。單因素分析結(jié)果顯示：女性手術(shù)率1.0%,男性手術(shù)率為1.6%(P=0.048)；50-59歲組手術(shù)率為0.0%,60-69歲組手術(shù)率為1.2%,70-79歲組手術(shù)率為3.7%,80歲及以上組手術(shù)率4.2%(P=0.000)；文盲組手術(shù)率為1.7%,小學(xué)以下組手術(shù)率為0.1%,小學(xué)組手術(shù)率為0.3%,初中及以上組手術(shù)率為0.7%(P=0.034)；在婚者手術(shù)率為0.8%,獨(dú)身者手術(shù)率為3.7%(P=0.000)；人均年收入0-元組手術(shù)率為2.8%,1000-元組為1.5%,3000-元組為0.7%,5000-元組為0.7%(P=0.000)；低保戶居民手術(shù)率為4.5%,非低保戶居民手術(shù)率為1.2%(P=0.000)；有醫(yī)療保障者手術(shù)率為1.4%,無醫(yī)療保障者為0.4%(P=0.041)；自評健康好、中、差者手術(shù)率依次為1.0%、1.3%、3.4%(P=0.000)；自感視力狀況好、中、差、盲者手術(shù)率依次為0.2%、1.1%、4.1%、9.7%(P=0.000)；自感眼部不適者手術(shù)率為2.2%,無不適者為1.2%(P=0.017)；認(rèn)為白內(nèi)障可以治愈者手術(shù)率為1.8%,不可治愈者為0.7%,不清楚者為1.0%(P=0.024)。多因素分析結(jié)果顯示,年齡、自感視力狀況、白內(nèi)障能否治愈認(rèn)知及有無醫(yī)療保障是白內(nèi)障手術(shù)率的影響因素。(3)應(yīng)當(dāng)施行白內(nèi)障手術(shù)97人中,接受白內(nèi)障手術(shù)人數(shù)為35人,白內(nèi)障手術(shù)覆蓋率為36.1%。單因素分析結(jié)果顯示：女性手術(shù)覆蓋率35.6%,男性手術(shù)覆蓋率為37.5%(P=0.868)；50-59歲組手術(shù)覆蓋率為25.0%,60-69歲組手術(shù)覆蓋率為45.0%,70-79歲組手術(shù)覆蓋率為46.8%,80歲及以上組手術(shù)覆蓋率11.5%(P=0.018)；文盲組手術(shù)覆蓋率為37.2%,小學(xué)以下組手術(shù)覆蓋率為50.0%,小學(xué)組手術(shù)覆蓋率為0.0%,初中及以上組手術(shù)覆蓋率為33.3%(P=0.587)；在婚者手術(shù)率為30.2%,獨(dú)身者手術(shù)覆蓋率為40.7%(P=0.284)；人均年收入0-元組手術(shù)覆蓋率為35.7%,1000-元組為38.7%,3000-元組為20.0%,5000-元組為42.9%(P=0.683)；低保戶居民手術(shù)覆蓋率為55.6%,非低保戶居民手術(shù)覆蓋率為34.1%(P=0.202)；有醫(yī)療保障者手術(shù)覆蓋率為41.3%,無醫(yī)療保障者為11.8%(P=0.022)；自評健康好、中、差者手術(shù)覆蓋率依次為37.5%、33.3%、40.0%(P=0.857)；自感眼部不適者手術(shù)覆蓋率為42.3%,無不適者為33.8%(P=0.440)；認(rèn)為白內(nèi)障可以治愈者手術(shù)覆蓋率為45.0%,不可治愈者為25.0%,不清楚者為31.1%(P=0.286)。 結(jié)論 (1)山東省滕州市50歲及以上居民白內(nèi)障患病率為26.6%,白內(nèi)障手術(shù)率為1.3%,白內(nèi)障手術(shù)覆蓋率36.1%；(2)白內(nèi)障患病率與性別、年齡、婚姻狀況、受教育程度、人均年收入、自評健康、親屬有無盲及低視力及飲酒狀況等因素相關(guān)；(3)白內(nèi)障手術(shù)率與年齡、自感視力狀況、白內(nèi)障能否治愈認(rèn)知及有無醫(yī)療保障等因素相關(guān)；(4)白內(nèi)障手術(shù)覆蓋率與年齡及有無醫(yī)療保障等因素相關(guān)。
[Abstract]:Background Our country is one of the three blind people in the world , about 7 million blind people , accounting for 18 % of the total number of blind people in the world .

Objective To investigate the prevalence of cataract , cataract operation rate and operative coverage rate among residents aged 50 and above in Tengzhou City , Shandong Province , and to analyze the influencing factors .

Methods All administrative villages in Tengzhou city were divided into basic sampling units ( BSU ) , 27 survey points were randomly selected , and eye examinations and questionnaires were carried out on the population aged 50 and above . The field inspection and investigation were conducted in April to July 2008 .

Results A total of 5,57 people aged 50 years and over were enrolled in the study , 4916 were actually tested , and the response rate was 88.46 % . ( 1 ) The prevalence rate was 26 . 6 % . Results of single factor analysis showed that the prevalence rate was 29 . 8 % and the prevalence rate of men was 22.6 % ( P = 0.000 ) .
The prevalence of the 50 - 59 age group was 6.6 % , the prevalence of the 60 - 69 years group was 27 . 1 % , the prevalence of 70 - 79 years group was 58.1 % , and the prevalence rate was 78.5 % ( P = 0.000 ) .
The prevalence of illiterate group was 33.4 % , the prevalence rate was 15.6 % in primary school , 14.4 % in primary school group , 12.1 % in middle school and above group ( P = 0.000 ) .
The prevalence of unmarried persons was 21.1 % and the prevalence rate was 55.3 % ( P = 0.000 ) .
The incidence of per capita annual income 0 - tuple was 50.6 % , 1000 - tuple was 28 . 8 % , 3000 - tuple was 19.4 % , and 5000 - tuple was 14.6 % ( P = 0.000 ) ;
The prevalence of low - income households was 48.3 % , and the prevalence rate of non - low - income residents was 25 . 8 % ( P = 0.000 ) .
The prevalence of poor health was 19.5 % , 31 . 2 % and 42 . 8 % ( P = 0.000 ) .
The prevalence of blindness and low vision in relatives was 34.0 % , and the prevalence rate was 26.1 % ( P = 0.002 ) .
The prevalence of non - smokers was 24 . 4 % , and the prevalence of smokers was 27.3 % , and the prevalence rate was 33.5 % ( P = 0.004 ) .
The prevalence rate of non - drinkers was 17.3 % , the prevalence of occasional drinking was 24.2 % , and the prevalence rate of frequent drinkers was 29 . 4 % , and the prevalence rate was 27.0 % ( P = 0.000 ) .
The results of multivariate analysis showed that the incidence of sex , age , marital status , degree of education , per capita annual income , self - assessment health , relative lack of blindness and low vision and alcohol consumption were the risk factors of cataract .
The operative rate was 0 . 0 % for 50 - 59 year old group , 1.2 % for 60 - 69 year old group , 3.7 % for 70 - 79 year group , and 4.2 % for group 80 and above ( P = 0.000 ) .
The operative rate was 1.7 % in the illiterate group , 0.1 % in the primary school group , 0.3 % in the primary school group , 0.7 % in the middle school and above group ( P = 0.034 ) .
The operative rate was 0.8 % and the rate of single body operation was 3.7 % ( P = 0.000 ) .
The per capita annual income of 0 - tuple was 2.8 % , 1000 - tuple was 1.5 % , 3000 - tuple was 0.7 % , and 5000 - tuple was 0.7 % ( P = 0.000 ) .
The surgical rate of low - care residents was 4.5 % , and the surgical rate of non - low - care residents was 1.2 % ( P = 0.000 ) .
The operative rate of the patients with medical security was 1.4 % and 0.4 % ( P = 0.041 ) .
The operative rate of the self - evaluation was 1.0 % , 1.3 % and 3.4 % ( P = 0.000 ) .
The operative rate of the blind was 0.2 % , 1.1 % , 4.1 % and 9.7 % ( P = 0.000 ) .
The operative rate was 2.2 % for patients with self - feeling and 1.2 % for patients without discomfort ( P = 0 . 017 ) .
The result of single factor analysis showed that the rate of cataract surgery was 35 . 6 % , and the rate of surgical coverage was 37.5 % ( P = 0.868 ) .
The operative coverage rate of the 50 - 59 year - old group was 25.0 % , the operative coverage rate of the 60 - 69 year - old group was 45.0 % , the operative coverage rate of the 70 - 79 year - old group was 46.8 % , and the operative coverage rate was 11.5 % in the 80 - year - old group and the above group ( P = 0 . 018 ) .
The operative coverage rate was 37.2 % in the illiterate group , 50.0 % in primary school group , 0.0 % in primary school group , 33.3 % in junior middle school and above group ( P = 0.587 ) .
The operative rate of the patients was 30 . 2 % , and the coverage rate was 40.7 % ( P = 0.284 ) .
The per capita annual income of 0 - tuple was 35.7 % , 1000 - tuple was 38.7 % , 3000 - tuple was 20.0 % , and 5000 - tuple was 42.9 % ( P = 0.683 ) .
The operation coverage rate of low - care residents was 55.6 % , and the coverage rate of non - low - care residents was 39.1 % ( P = 0.202 ) .
The operative coverage rate was 41.3 % and 11.8 % ( P = 0 . 022 ) .
The coverage of surgical coverage was 37.5 % , 33.3 % and 40.0 % ( P = 0.857 ) .
The operative coverage rate of patients with self - sensing eye discomfort was 42.3 % and 33.8 % ( P = 0.440 ) .
The rate of operation coverage of cataract was 45.0 % and 25.0 % was not clear , and 31 . 1 % was not clear ( P = 0.286 ) .

Conclusion

( 1 ) The incidence of cataract in Tengzhou city of Shandong province was 26 . 6 % , cataract surgery rate was 1.3 % , and cataract surgery coverage was 36 . 1 % ;
( 2 ) The prevalence of cataract is related to sex , age , marital status , educational attainment , per capita annual income , self - assessment health , relatives ' lack of blindness and low vision and alcohol consumption .
( 3 ) The cataract surgery rate is related to age , self - visual acuity , the ability of cataract to cure cognition and the presence or absence of medical security .
( 4 ) The coverage of cataract surgery is related to age and medical security .
【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R195.4;R776.1

【參考文獻(xiàn)】

中國期刊全文數(shù)據(jù)庫 前10條

1 徐益華;重慶市1045人白內(nèi)障患病率的調(diào)查報(bào)告[J];美中國際眼科雜志;2001年04期

2 左宏宇;吸煙與核性白內(nèi)障關(guān)系的臨床觀察[J];國際眼科雜志;2003年03期

3 彭秧生;周愛意;陳莉;何媛;任百超;;陜西省農(nóng)村50歲以上人群白內(nèi)障和盲的患病率調(diào)查[J];國際眼科雜志;2007年01期

4 李晶晶;徐亮;;中老年人視力損害的流行病學(xué)研究概況[J];國際眼科縱覽;2006年05期

5 丁琳;趙秀蓉;楊昕;史韶華;;新疆烏魯木齊市白內(nèi)障的流行病學(xué)調(diào)查[J];新疆醫(yī)學(xué);2005年01期

6 曹曉光,鮑永珍,胡建信,朱彤,陳捷,曲進(jìn)峰,王金良,黎曉新;青海省平安縣年齡相關(guān)性白內(nèi)障的流行病學(xué)調(diào)查[J];眼科研究;2005年05期

7 趙家良,賈麗君,睢瑞芳,LeonBEllwein,張承訓(xùn),降麗娟,張紅,孫國強(qiáng),宋學(xué)峰,毛進(jìn);北京市順義縣50歲及以上人群中盲患病率調(diào)查[J];中華眼科雜志;1999年05期

8 趙家良,睢瑞芳,賈麗君,LeonB-Ellwein,張承訓(xùn),降麗娟,張紅,孫國強(qiáng),宋學(xué)峰,毛進(jìn);北京市順義區(qū)白內(nèi)障患病和手術(shù)狀況的調(diào)查[J];中華眼科雜志;2001年01期

9 趙家良;“視覺2020”行動(dòng)與我國防盲治盲工作[J];中華眼科雜志;2002年10期

10 閆佳;盧智泉;;維生素C及維生素E與年齡相關(guān)白內(nèi)障[J];中華臨床醫(yī)師雜志(電子版);2011年09期

中國博士學(xué)位論文全文數(shù)據(jù)庫 前1條

1 李世宏;重慶主城區(qū)先天性白內(nèi)障手術(shù)調(diào)查及手術(shù)對眼前節(jié)影響的研究[D];第三軍醫(yī)大學(xué);2009年

中國碩士學(xué)位論文全文數(shù)據(jù)庫 前1條

1 方媛;山東省滕州市50歲及以上居民盲與低視力現(xiàn)狀研究[D];山東大學(xué);2009年

，

本文編號：1987459