目的：了解西陵区儿童青少年常见病患病情况，为采取针对性的干预措施提供依据与参考。方法：采用分层整群抽样的方法选取西陵辖区内2所幼儿园、2所小学、2所初中、2所高中、1所职高的学校开展学生常见病监测。结果共调查2508名学生的视力，视力不良率65.23%，学生筛查性近视率55.62%；女生近视率(56.68%)高于男生(54.74%)，高中生的近视率最高(77.89%)、幼儿园幼儿最低(9.26%)，不同学段的近视率差异有统计学意义(P值 < 0.001)。检测2346名中小学生的龋齿、脊柱弯曲异常和营养状况，发现龋患率为16.28%、营养不良率为5.75%、超重率为17.90%和肥胖率为14.36%，脊柱弯曲异常率为1.79%。除龋患率女生高于男生外；营养不良、超重、肥胖发生率男生均高于女生；以上差异均有统计学意义(P值均 < 0.05)。结果：本次调查纳入统计样本为2508名儿童及青少年学生，男生1370人(54.63%)，女生1138人(45.37%)；其中幼儿园162人(6.46%)，小学1030人(41.07%)，初中547人(21.81%)，高中769人(30.66%)。学生常见病检出率依次为视力不良率(65.23%)，近视率(55.62%)，龋患率(16.28%)，营养不良率(5.75%)，超重率(17.90%)，肥胖率(14.36%)，脊柱弯曲异常率(1.79%)。结论：西陵区学生常见病总体流行率处于普通水平，以近视和龋齿的罹患水平较高，各类常见病在年龄和性别分布上有其各自特点。卫健部门、教育部门及家庭三方应相互协作，采取针对性的干预措施，改善学生健康状况。

儿童青少年，常见病，近视

Jun Liu^*, Zhao Zhou^#

Center for Disease Control and Prevention, Public Health Surveillance Section, Xiling District, Yichang Hubei

Received: Jan. 8^th, 2024; accepted: Feb. 22^nd, 2024; published: Feb. 29^th, 2024

Objective: To understand the prevalence of common diseases among children and adolescents in Xiling District, and to provide a basis and reference for targeted interventions. Methods: Two kindergartens, two elementary schools, two junior high schools, two senior high schools and one vocational high school in Xiling district were selected by stratified cluster sampling to monitor common diseases among students. As a result, the visual acuity of 2508 students was investigated, and the rate of poor vision was 65.23%, and the screening myopia rate of students was 55.62%; the myopia rate of female students (56.68%) was higher than that of male students (54.74%), and the myopia rate of senior high school students was the highest (77.89%) and kindergarteners was the lowest (9.26%), and the difference of myopia rate between different school segments was statistically significant (p-value < 0.001). Detecting dental caries, abnormal spinal curvature and nutritional status of 2,346 primary and secondary school students, it was found that the caries rate was 16.28%, the malnutrition rate was 5.75%, the overweight rate was 17.90% and the obesity rate was 14.36%, and the abnormal spinal curvature rate was 1.79%. Except for the rate of caries, which was higher in girls than in boys; the incidence of malnutrition, overweight and obesity was higher in boys than in girls; all the above differences were statistically significant (all P-values < 0.05). Results: The survey included a statistical sample of 2508 children and adolescent students, 1370 boys (54.63%) and 1138 girls (45.37%); of which 162 were in kindergarten (6.46%), 1030 were in elementary school (41.07%), 547 were in junior high school (21.81%), and 769 were in high school (30.66%). The detection rates of common diseases among students were, in order, poor vision (65.23%), myopia (55.62%), caries (16.28%), malnutrition (5.75%), overweight (17.90%), obesity (14.36%), and abnormalities of spinal curvature (1.79%). Conclusion: The overall prevalence of common diseases among students in Xiling District is at an average level, with high levels of myopia and dental caries, and each type of common disease has its own characteristics in terms of age and gender distribution. The health department, education department and families should collaborate with each other and take targeted interventions to improve the health status of students.

Keywords:Children and Adolescents, Common Diseases, Myopia

Copyright © 2024 by author(s) and beplay安卓登录

This work is licensed under the Creative Commons Attribution International License (CC BY 4.0).

http://creativecommons.org/licenses/by/4.0/

学生常见病是指广大中小学校和托幼机构的儿童青少年，因生长发育特征、学习生活环境、营养膳食等因素影响，而导致的一组比较常见的、多发性疾病，主要包括龋齿、寄生虫、营养不良、超重肥胖、缺钙性贫血、视力不良和脊柱弯曲异常等 [ 1 ] [ 2 ] 。为认真贯彻落实习近平总书记关于儿童青少年近视防控工作的重要指示精神，推进落实《综合防控儿童青少年近视实施方案》和《“健康湖北2030”行动纲要》，着力实施“健康宜昌、幸福西陵”行动方案中有关学生常见病和健康影响因素监测工作。根据《2023年全国学生常见病和健康影响因素监测与干预工作方案》等相关要求，新组建成立的宜昌市西陵区疾控中心组织开展了2023年学生常见病和健康影响因素监测工作，掌握儿童青少年近视、肥胖等常见病现状，了解西陵区儿童青少年常见病发展趋势，分析影响儿童青少年健康的主要危害因素，研判儿童青少年主要健康风险，提出并采取干预措施，保障和促进儿童青少年健康。

我国学生患病检出率最高的常见病是近视，已严重危害到我国学生健康，根据国家卫健委、教育部等多部门印发的《综合防控儿童青少年近视实施方案》要求 [ 8 ] ，西陵区不同学段近视率与2030年近视综合控制目标均还相差甚远。2020我国儿童青少年近视率为52.7%，而调查结果显示2023年西陵区儿童青少年近视率为55.62%，高于2020年全国平均水平。近年来，由于电子产品的广泛应用，频繁长时间、近距离用眼以及户外阳光活动少等多方面的原因，导致儿童青少年近视率呈现低龄化，持续攀升的趋势；中学生由于学习时间长、学习压力大，户外活动少等原因，中学生近视率远高于小学生，与我国其他地区研究结果一致 [ 9 ] [ 10 ] [ 11 ] 。另外，受到新冠疫情影响，疫情三年学生上网课时间大大增加，对儿童青少年视力产生了较大影响 [ 12 ] 。值得关注的是，根据教室环境监测结果显示，黑板面平均照度合格率仅为33.30%，课桌面平均照度合格率仅为64.30%，教室光照不足会对学生的视力产生不良影响，评估学校教室环境卫生状况，加强对学校教室环境的改善工作，也是学生近视防治的有效且重要的一环。

西陵区学生龋患率为16.28%，明显低于全国全省平均水平 [ 9 ] [ 10 ] [ 11 ] ，这得益于西陵区长期坚持全国慢性病综合防控示范区、以及全国牙病防治示范区等创建工作。在公众中普及牙病防治知识，增强口腔健康观念和自我口腔保健的意识，建立口腔保健的习惯，从而提高口腔健康水平。女生龋患率(18.40%)明显高于男生(14.54%)，与何丽丽等的调查结果一致 [ 13 ] ，可能与女生更喜欢摄入含糖量较高的食物，如奶茶、蛋糕等有关，且一般来说，女生户外运动较男生少，体内维生素D合成少，影响机体发育，抗龋能力下降。中小学生恒牙患率随学段的上升而增加，不同学段学生的龋患率差异有统计学意义，这与从恒牙替换乳牙开始，随着在外暴露时间的增加，受到各种有害因素的侵蚀，使得龋患率随着年龄的增加而不断增长 [ 14 ] 。

儿童青少年营养状况问题较为突出，且超重和肥胖问题较营养不良问题更突出，与中国九省的调查结果一致 [ 15 ] 。本次监测结果显示西陵区学生超重和肥胖检出率分别为17.90%和14.36%，但与全国全省学生超重肥胖情况相比仍处于中等水平 [ 9 ] [ 10 ] [ 11 ] 。男生超重肥胖率均明显高于女生，这可能与女生爱美意识更强，注重体型的保养，男生较女生缺乏控制体型的意识，饮食不均衡有关 [ 16 ] [ 17 ] 。营养不良检出率也存在性别差异，男生显著高于女生，可能是由于男生运动量大，能量消耗大，而且进入青春期以后男生的生长发育速度更快，摄入的营养物质不能满足机体需求 [ 17 ] 。

脊柱弯曲异常检出率较低，与全国全省学生脊柱弯曲异常情况相比基本一致 [ 12 ] 。但随着年龄增长，脊柱弯曲检出率不断增高，高中生脊柱弯曲检出率最高(3.90%)，这可能与长时间学习保持相同姿势、坐姿不当、缺乏适量的体育锻炼等因素有关 [ 18 ] [ 19 ] 。值得关注的是，教室环境卫生监测显示课桌椅分配符合率仅6.20%，这将对脊柱弯曲异常的发生产生不良影响。

综上所述，西陵区学生常见病总体流行率处于普通水平，以近视和龋齿的罹患水平较高，各类常见病在年龄和性别分布上有其各自特点 [ 8 ] [ 9 ] [ 10 ] [ 11 ] [ 12 ] 。建议全面加强学校健康教育和健康促进工作，建立完善政府主导、部门联动、学校落实、家庭参与、社会动员的工作机制，明确职责分工，加强沟通协作，有效建立“五位一体”学生常见病防控体系(卫生健康部门、教育部门、家庭、学校、医院)，有效控制健康危险因素，减少常见健康危害，提升健康素养和健康水平，积极推进儿童青少年常见病防控工作 [ 20 ] [ 21 ] 。

刘 俊,周 钊. 2023年宜昌市西陵区儿童青少年常见病监测结果分析Common Diseases of Children and Adolescents in Xiling District, Yichang City, 2023 Analysis of Monitoring Results[J]. 统计学与应用, 2024, 13(01): 181-188. https://doi.org/10.12677/SA.2024.131020