目的：了解西安市中小学生视力和戴镜情况，为开展近视防控工作提供科学依据。 方法：在西安市16个区县对119所中小学校38226名学生开展视力筛查和戴镜情况调查，对裸眼视力、屈光度、戴镜率、足矫率等进行统计分析。 结果：西安市中小学近视率为61.53%，随着学段增加而递增（?2趋势=5332.203，p＜0.01），其中轻度近视率占比随着学段的升高而降低，中度、高度占比随着学段的升高呈上升趋势（?2趋势=2671.562，p＜0.01）。近视学生戴镜率为51.69%，戴镜率随着学段的升高呈上升趋势（?2趋势=1486.941，p＜0.01），女生戴镜率高于男生（?2=23.659，P＜0.01），城区戴镜率高于郊县（?2=102.241，P＜0.01）。戴镜学生足矫率为67.08%，城区戴镜学生足矫率高于郊县（?2=4.980，p＜0.05）。近视学生过去一年内视力检查频次≥2次的占63.66%，职业高中学生两次视力检查频次最低为58.06%。近视学生居住在郊县与戴镜率呈负相关，学段升高、每年视力检查频次增多与近视学生戴镜率呈正相关。 结论：西安市学生近视防控形势严峻，学生戴镜率、足矫率、视力检查频次低，需要重点关注郊县、小学、职业高中学生视力矫正情况。

Objective To understand the situation of vision and spectacle usage among primary and secondary school students in Xi’an city, providing scientific evidence for carrying out myopia prevention and control efforts. Methods We conducted a vision screening and spectacles usage survey among 38226 students in 119 primary and secondary schools from 16 counties and districts in Xi’an city, performing statistical analysis on unaided visual acuity, refractive power, glasses wearing rate, full correction rate, etc. Results The myopia rate among primary and secondary school students in Xi’an city is 61.53%, showing an increasing trend as the grade level goes up (?2趋势 = 5332.23, p <0.01). Among them, the proportion of mild myopia decreases with the increase of grade level, while the proportion of moderate and high myopia shows an upward trend with the increase of grade level(?2趋势 = 2671.562, p< 0.01). The glasses wearing rate among myopic students is 51.69%, showing an upward trend as the grade level goes up(?2趋势= 1486.941, p< 0.01). The spectacle prescription rate for female students is higher than that for male students(c2= 23.659, p< 0.01), and the rate in urban areas is higher than that in suburban counties(?2= 102.241，p< 0.01). The full correction rate among students wearing glasses is 67.08%, and the rate for students wearing glasses in urban areas is higher than that in suburban counties(?2 = 4.980, p< 0.05). Among myopic students, 63.66% had undergone visual acuity checks more than or equal to twice in the past year, with vocational high school students having the lowest frequency of twice vision screenings, accounting for 58.06%. There is a negative correlation between myopic students residing in suburban counties and their glasses wearing rate, while a higher grade level and increased frequency of annual vision checks are positively correlated with the glasses wearing rate among myopic students. Conclusion The situation of students myopia prevention and control is severe in Xi’an city, with low rates of spectacles usage, full correction, and frequency of visual checks. Special attention needs to be paid to the vision correction status of students in suburban counties, primary schools, and vocational high schools.

西安市儿童青少年近视风险预警模型构建及分层管理模式研究