秒词邦

原文：

　近视已成为影响我国国民尤其是儿童青少年眼健康的重大公共卫生问题。为进一步提高近视防控和诊疗的规范化水平，做好儿童青少年近视的防治工作，国家卫生健康委日前发布《近视防治指南（2024年版）》。

　儿童青少年近视防控向好，加强公共卫生层面指导

　　国家卫生健康委妇幼司副司长沈海屏说，近年来，国家卫生健康委大力推动儿童青少年近视综合防控工作，取得积极进展：全国0—6岁儿童眼保健和视力检查覆盖率达到95.1%；2022年儿童青少年总体近视率、6岁儿童近视率分别达51.9%、12.7%，与2018年相比分别下降了1.7和1.8个百分点，呈现向好态势。同时，儿童青少年近视防控工作仍然任重道远。

　　全国防盲技术指导组组长、北京同仁医院眼科中心主任王宁利介绍，2018年6月国家卫生健康委发布了《近视防治指南》。随着国内外近视研究的进展，近视防治技术和措施不断发展。国家卫生健康委牵头组织全国防盲技术指导组对《近视防治指南》进行修订，形成了《近视防治指南（2024年版）》。

　　王宁利说，近视既要重视预防和控制，又要重视针对病理性近视相关眼底病变及并发症的治疗，此次指南涵盖这两方面措施。在开展近视防治服务的过程中，各级医疗机构要严格遵守相关诊疗指南、技术操作规范、临床路径、药品说明书等，确保医疗质量和安全。

　　此次指南将近视防控分为近视前驱期、近视发展期、高度近视期、病理性近视期，并对不同分期给出了近视防控措施的指导建议。为什么要增加公共卫生层面近视防控策略分期？王宁利解释，临床诊疗上关于近视的分类，不能很好地指导公共卫生层面近视的预防和控制。增加公共卫生层面分期，可以将防控措施和技术针对性落实到不同屈光状态人群，从而更加精准地指导防控工作开展。

　　关口前移，保障户外活动时间量

　　孩子刚出生时，眼球很小，眼轴很短，这时双眼处于生理性的远视状态，具有一定的远视度数，被称为远视储备量。

　　王宁利介绍，与年龄对应的远视储备量是近视发生的最佳预测指标。如果儿童青少年过早、过多地近距离用眼，就会导致远视储备量低于其年龄对应的标准范围，如果小学一年级时远视储备量已消耗完，在小学阶段就极易发展为近视。为保护儿童远视储备量，应当把近视防控前移到学龄前儿童。

　　沈海屏说，国家卫生健康委推动近视预防关口前移，规范0—6岁儿童眼保健和视力检查服务，在24月龄、36月龄和4—6岁时开展屈光筛查，检查儿童的远视储备量。“如果检测发现孩子远视储备量已经不足，我们会提示家长指导孩子建立良好的用眼习惯，加强体育锻炼，经常参加户外活动，亲近大自然。”

　　王宁利认为，户外活动可以有效防控儿童青少年近视，首先要保障户外活动的时间量，每天户外活动时间不少于2小时。不仅在学校要多进行课间户外活动，放学后和周末，家长或监护人也要积极带孩子到户外活动。

　　我国将儿童青少年近视防控工作纳入“十四五”国民健康规划和中国儿童发展纲要。国家卫生健康委会同多部门开展防控工作评议考核，推动各地建立政府主导、部门协作工作机制，促进学校、家庭、医疗卫生机构和全社会共同行动。鼓励医疗机构和学校建立协同机制，为中小学生提供健康教育、屈光筛查、视力检查和规范的矫治服务。加大科普宣传力度，重点宣传预防近视要从小从早做起、养成良好用眼习惯、分年龄段限制视频类电子产品使用、每天坚持做眼保健操等科学知识，指导家长从小抓好儿童近视预防。

　　“我们将聚焦推动防控关口前移，重点抓好0—6岁儿童眼保健和视力检查服务落实，抓早抓小，加强科普宣传，全力呵护好孩子们的眼睛。”沈海屏说。

　　避免近视度数过快增长，预防高度近视相关眼病

　　王宁利说，对儿童青少年采取有效的干预措施，避免近视度数过快增长十分重要。因此，此次指南进一步明确了近视的矫正和控制措施，加强对医疗卫生机构、近视防控专业技术人员等的指导。

　　需要注意的是，近视矫正手术是通过手术方式改变眼的屈光度，术后近视患者的眼底结构并未发生改变。尤其是高度近视患者，由于眼轴拉长，多伴有眼底病变，这些眼底病理性改变依然存在，近视并没有从根本上治愈。因此，术后仍要注意用眼卫生，有眼底病变的近视患者，依然需要定期做检查。此外，角膜塑形镜和多焦软镜等器械及低浓度阿托品滴眼液，都只是控制近视进展的措施，使用后也不能从根本上治愈近视。

　　王宁利提醒，由于眼底病变，高度近视易进展为病理性近视，进而可导致多种眼部并发症。病理性近视相关眼底病变已成为我国不可逆性致盲眼病的主要原因之一，其引起的眼部并发症包括后巩膜葡萄肿、周边视网膜血管异常、黄斑萎缩、孔源性视网膜脱离等眼底疾病，青光眼、白内障、斜视等眼部疾病的风险也显著增加。因此，高度近视患者在保护视力的同时，更应防控相关的眼部并发症，减少致残致盲的风险。

译文：

Myopia has become a major public health issue affecting the eye health of Chinese citizens, especially children and adolescents. In order to further improve the standardization level of myopia prevention and treatment, and to do a good job in the prevention and treatment of myopia in children and adolescents, the National Health Commission recently released the "Guidelines for the Prevention and Treatment of Myopia (2024 Edition)".

Improving prevention and control of myopia in children and adolescents, strengthening guidance on public health

Shen Haiping, Deputy director of the Women and Children's department of the National Health Commission, said that in recent years, the National Health Commission has vigorously promoted the comprehensive prevention and control of myopia in children and adolescents, and has made positive progress: the coverage rate of eye care and vision examinations for children aged 0-6 in China has reached 95.1%; In 2022, the overall myopia rate of children and adolescents, as well as the myopia rate of 6-year-old children, reached 51.9% and 12.7%, respectively, a decrease of 1.7 and 1.8 percentage points compared to 2018, showing a positive trend. At the same time, the prevention and control of myopia in children and adolescents still has a long way to go.

Wang Ningli, leader of the National Blindness Prevention Technology Guidance Group and director of the Ophthalmology center of Beijing Tongren Hospital, introduced that in June 2018, the National Health Commission issued the "Guidelines for the Prevention and Treatment of Myopia.". With the progress of myopia research both domestically and internationally, myopia prevention and treatment technologies and measures are constantly evolving. The National Health Commission led the organization of the National Blindness Prevention Technical Guidance Group to revise the Myopia Prevention and Treatment Guidelines, forming the Myopia Prevention and Treatment Guidelines (2024 Edition).

Wang Ningli said that myopia should not only be prevented and controlled, but also treated for pathological myopia related fundus lesions and complications. This guideline covers these two measures. In the process of providing myopia prevention and treatment services, medical institutions at all levels must strictly abide by relevant diagnosis and treatment guidelines, technical operation standards, clinical pathways, drug instructions, etc., to ensure medical quality and safety.

This guide divides myopia prevention and control into three stages: pre myopia stage, myopia development stage, high myopia stage, and pathological myopia stage, and provides guidance and suggestions for myopia prevention and control measures for different stages. Why increase the staging of myopia prevention and control strategies at the public health level? Wang Ningli explained that the classification of myopia in clinical diagnosis and treatment cannot effectively guide the prevention and control of myopia at the public health level. By increasing the staging of public health, targeted prevention and control measures and technologies can be implemented for people with different refractive states, thereby providing more accurate guidance for prevention and control work.

Move the checkpoint forward to ensure sufficient outdoor activity time

When a child is born, their eyeballs are small and their eye axis is short. At this time, their eyes are in a physiological state of hyperopia, with a certain degree of hyperopia, which is called hyperopia reserve.

Wang Ningli introduced that the age corresponding hyperopia reserve is the best predictive indicator of myopia occurrence. If children and adolescents use their eyes at close range too early or too much, it will lead to their hyperopia reserve being lower than the standard range corresponding to their age. If the hyperopia reserve is depleted by the first grade of primary school, it is very easy to develop myopia in primary school. To protect children's reserves of farsightedness, myopia prevention and control should be moved to preschool children.

Shen Haiping said that the National Health Commission has moved the focus of myopia prevention forward, standardized eye care and vision examination services for children aged 0-6, and conducted refractive screening at 24 months, 36 months, and 4-6 years old to check children's hyperopia reserves. "If the test shows that the child's farsightedness reserve is insufficient, we will prompt parents to guide their child to establish good eye habits, strengthen physical exercise, regularly participate in outdoor activities, and get close to nature."

Wang Ningli believes that outdoor activities can effectively prevent and control myopia in children and adolescents. Firstly, it is necessary to ensure the amount of outdoor activity time, with no less than 2 hours of outdoor activity time per day. Not only should there be more outdoor activities during breaks in school, but parents or guardians should also actively take their children to outdoor activities after school and on weekends.

China has included the prevention and control of myopia in children and adolescents in the 14th Five Year Plan for National Health and the Outline for Children's Development in China. The National Health Commission, together with multiple departments, carries out evaluation and assessment of prevention and control work, promotes the establishment of government led and departmental collaborative work mechanisms in various regions, and promotes joint action by schools, families, medical and health institutions, and the whole society. Encourage medical institutions and schools to establish collaborative mechanisms to provide health education, refractive screening, visual acuity testing, and standardized corrective services for primary and secondary school students. Intensify science popularization efforts, with a focus on promoting scientific knowledge such as starting from an early age, cultivating good eye habits, limiting the use of video electronic products by age groups, and doing eye exercises every day to prevent myopia in children. Guide parents to focus on preventing myopia in children from an early age.

"We will focus on promoting the advancement of prevention and control measures, with a focus on ensuring the implementation of eye health and vision examination services for children aged 0-6. We will focus on early detection and early detection, strengthen science popularization and publicity, and make every effort to take good care of children's eyes," said Shen Haiping.

To avoid rapid growth of myopia and prevent high myopia related eye diseases

Wang Ningli said that it is very important to take effective intervention measures for children and adolescents to avoid the rapid growth of myopia. Therefore, this guide further clarifies the correction and control measures for myopia, and strengthens guidance for medical and health institutions, professional and technical personnel in myopia prevention and control.

It should be noted that myopia correction surgery changes the refractive power of the eye through surgical means, and the fundus structure of myopic patients does not change after surgery. Especially for patients with high myopia, due to the elongation of the eye axis, there are often fundus lesions, and these pathological changes in the fundus still exist. Myopia has not been fundamentally cured. Therefore, postoperative attention should still be paid to eye hygiene, and myopic patients with fundus lesions still need regular examinations. In addition, instruments such as corneal reshaping lenses, multifocal soft lenses, and low concentration atropine eye drops are only measures to control the progression of myopia, and their use cannot fundamentally cure myopia.

Wang Ningli reminds that due to fundus lesions, high myopia can easily progress to pathological myopia, which can lead to various eye complications. Pathological myopia related fundus lesions have become one of the main causes of irreversible blindness in China. The ocular complications caused by them include posterior staphyloma, peripheral retinal vascular abnormalities, macular atrophy, rhegmatogenous retinal detachment, and other fundus diseases. The risk of ocular diseases such as glaucoma, vitiligo, and strabismus has also significantly increased. Therefore, high myopia patients should not only protect their vision, but also prevent and control related eye complications to reduce the risk of disability and blindness.

句子分析1：

To protect children's reserves of farsightedness, myopia prevention and control should be moved to preschool children.

句子成分分析：(划分说明)  

To protect children's reserves (of farsightedness, myopia prevention and control) should be moved to preschool children.

句子语法结构详解：

(children 为 child 的复数形式。)

* To protect 为不定式，在句中作主语。
* moved 为谓语，采用被动语态。
* should 为情态动词。be 为助动词。children's 为名词所有格。

相关语法知识:
   不定式
   并列连词
   被动语态
   名词所有格 | 情态动词 | 助动词

句子相关词汇解释：

Vocabulary:

句子语法错误检查：

(未发现错误)

句子分析2：

To avoid rapid growth of myopia and prevent high myopia related eye diseases

句子成分分析：(划分说明) 

To avoid rapid growth (of myopia) and prevent high myopia related eye diseases

句子语法结构详解：

* To avoid 为不定式，在句中作主语。
* prevent 为不带 to 的不定式。
* related 为谓语，采用一般过去时。

相关语法知识:
   不定式
   并列连词
   时态

句子相关词汇解释：

Vocabulary:

句子语法错误检查：

(未发现错误)

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