٥٢
ﻲﻤﺸﭼ يﺎﻬﻳرﺎﻤﻴﺑ ﻪﺑ نﺎﻳﻼﺘﺒﻣ نﺪﺷ يﺮﺘﺴﺑ ﻞﻠﻋ ﻲﺳرﺮﺑ
رد ﺪﻨﺟﺮﻴﺑ ﺮﻬﺷ يﺎﻬﻧﺎﺘﺳرﺎﻤﻴﺑ )
1380 -
1373 (
ﺮﺘﻛد ﻲﺑﻮﻘﻌﻳ ﻦﻴﺴﺤﻣﻼﻏ -1
ﻲﻨﻴﺴﺣ دﻮﻤﺤﻣ ﺪﻴﺳ
2
هﺪﻴﻜﭼ
فﺪﻫ و ﻪﻨﻴﻣز :
ﻪﻣﺎﻧﺮﺑ ﺖﻬﺟ نارﺎﻤﻴﺑ يﺮﺘﺴﺑ ﻞﻠﻋ و داﺪﻌﺗ ﻪﺑ ﻲﺑﺎﻴﺘﺳد تﺎﻧﺎﻜﻣا زا ﺮﺘﻬﺑ هدﺎﻔﺘﺳا و يﺰﻳر
، مزﻻ
ﻲﻣ ﺪﺷﺎﺑ . ﺷراﺰﮔ رد ﺎﻬ ي هﺪﻴﺳر ﻲﻧﺎﻬﺟ ﺖﺷاﺪﻬﺑ نﺎﻣزﺎﺳ و ﺎﻬﻧﺎﺘﺳرﺎﻤﻴﺑ ﻲﻀﻌﺑ زا نارﺎﻤﻴﺑ ﺺﻴﺧﺮﺗ سﺎﺳا ﺮﺑ
، ﺘﻌﻳﺎﺷ ﺮ ﻦﻳ
ﻢﺸﭼ يرﺎﻤﻴﺑ
، ﻲﻣ ﺖﻛارﺎﺗﺎﻛ ﺪﺷﺎﺑ
؛ ﻪﻌﻟﺎﻄﻣ ﺮﺿﺎﺣ رﻮﻈﻨﻣ ﻪﺑ ﻦﻴﻴﻌﺗ و داﺪﻌﺗ ﻞﻠﻋ يﺮﺘﺴﺑ نﺪﺷ ﻢﺸﭼ ﺶﺨﺑ رد نارﺎﻤﻴﺑ
ﺪﻨﺟﺮﻴﺑ ﺮﻬﺷ يﺎﻬﻧﺎﺘﺳرﺎﻤﻴﺑ ﻂﺳﻮﺗ ﺐﺳﺎﻨﻣ يﺎﻫرﺎﻜﻫار ،نآ ﺞﻳﺎﺘﻧ ﻪﺋارا ﺎﺑ ﺎﺗ ﺪﺷ مﺎﺠﻧا
ددﺮﮔ ذﺎﺨﺗا ﻦﻴﻟوﺆﺴﻣ .
شور ﻲﺳرﺮﺑ ﻪﻌﻟﺎﻄﻣ ﻦﻳا رد:
ﻲﻔﻴﺻﻮﺗ ﻪﻛ لﺎﺳ هﺎﻣﺮﻬﻣ زا 1373
ﺎﺗ ﺮﻬﻣ لﺎﺳ هﺎﻣ 1380
،ﺪﺷ مﺎﺠﻧا ﺺﻴﺨﺸﺗ
نارﺎﻤﻴﺑ يﺮﺘﺴﺑ هﺪﺷ سﺎﺳاﺮﺑ
ICD- 10
ﻪﮔﺮﺑ رد ﺪﻳدﺮﮔ ﺖﺒﺛ ﻪﻣﺎﻨﺸﺳﺮﭘ يﺎﻫ
؛ هداد ﺲﭙﺳ ﺎﻫ
ﺮﻈﻧ زا ﻲﮔﺪﻨﻛاﺮﭘ
رد تﺎﻋﻼﻃا ﺖﺸﻫ
ﻪﻘﺒﻃ ﻲﻤﺸﭼ يﺎﻬﻴﺘﺣارﺎﻧ زا هوﺮﮔ يﺪﻨﺑ
و ﺑ و ﻪﻳﺰﺠﺗ درﻮﻣ ﻲﻔﻴﺻﻮﺗ رﺎﻣآ يﺎﻬﺷور زا هدﺎﻔﺘﺳا ﺎ
ﻞﻴﻠﺤﺗ يرﺎﻣآ ﺘﻓﺮﮔ راﺮﻗ ﺪﻨ .
ﻪﺘﻓﺎﻳ ﺎﻫ : زا 523 رﺎﻤﻴﺑ يﺮﺘﺴﺑ هﺪﺷ ) 543 ﻢﺸﭼ (
، 5 / 45 % نز و 5 / 54 % ﺪﻧدﻮﺑ دﺮﻣ . ﺖﻛارﺎﺗﺎﻛ نﺎﻴﻣ ﻦﻳا زا 60
%
) 326 درﻮﻣ ( و ﻛﻮﻠﮔ مﻮ 7 / 3
% ) 20 ﺮﻔﻧ ( و ﻲﻳوراد نﺎﻣرد 3
/ 7 % ﻮﺑ د
؛ 2 ﺑ ﺖﻴﻟﺎﺘﻓوﺪﻧآ درﻮﻣ ﻪ
لﺎﺒﻧد ﻞﻤﻋ ﺖﻛارﺎﺗﺎﻛ و 1
ﻲﭼرﺎﻗ ﺖﻴﺗاﺮﻛ ﻪﺑ ﻼﺘﺒﻣ رﺎﻤﻴﺑ دﻮﺑ
. 6 / 2 ) % 14 ﺮﻔﻧ ( ﻪﺑ ﻼﺘﺒﻣ و ﻲﻜﺷا ياﺮﺠﻣ داﺪﺴﻧا 1
/ 3
% ) 17 ﺮﻔﻧ ( تﻼﻜﺸﻣ رﺎﭼد
ﻢﺸﭼ ﻚﻴﺘﺳﻼﭘ
؛ﺪﻧدﻮﺑ رد 6 / 11 % دراﻮﻣ ) 63 ﺮﻔﻧ ( ﻪﺑﺮﺿ و ﻢﺸﭼ يﺎﻫ رد
3 / 3
% ) 18 ﺮﻔﻧ ( ﻪﻴﻜﺒﺷ ﻲﮔﺪﺷاﺪﺟ دﻮﺟو
ﺖﺷاد .
ﻪﺠﻴﺘﻧ يﺮﻴﮔ : ﻤﻴﺑ ﺮﺘﺸﻴﺑ ﻪﻌﻟﺎﻄﻣ ﻦﻳا رد يﺮﺘﺴﺑ نارﺎ
ﺖﻠﻋ ﻦﻳﺮﺘﺸﻴﺑ ﻪﻛ ﻦﻳا ﻪﺑ ﻪﺟﻮﺗ ﺎﺑ ؛ﺪﻧدﻮﺑ ﺖﻛارﺎﺗﺎﻛ ﻪﺑ ﻼﺘﺒﻣ هﺪﺷ
ﻲﻣ ﺖﻛارﺎﺗﺎﻛ ﺎﻴﻧد رد يرﻮﻛ ﻲﻣ ﻪﻴﺻﻮﺗ ،ﺪﺷﺎﺑ
ﻞﻣاﻮﻋ ﻪﺑ ﻪﺟﻮﺗ ﺎﺑ و ﻊﻴﺳو دﺎﻌﺑا رد يرﺎﻤﻴﺑ ﻦﻳا ﺮﻄﺧ ﻞﻣاﻮﻋ دﻮﺷ
ﻪﻘﻄﻨﻣ ددﺮﮔ ﻲﺳرﺮﺑ يا .
هژاو يﺪﻴﻠﻛ يﺎﻫ :
ﻮﻟﻮﻴﻣﺪﻴﭘا ژ ي
؛ ﻢﺸﭼ يﺎﻬﻳرﺎﻤﻴﺑ ؛
نﺎﺘﺳرﺎﻤﻴﺑ ؛
ICD-10
ﻪﻠﺠﻣ ﺪﻨﺟﺮﻴﺑ ﻲﻜﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد ﻲﻤﻠﻋ )
هرود 11 هرﺎﻤﺷ ، 3 لﺎﺳ ، 1383 (
؛لوﺆﺴﻣ هﺪﻨﺴﻳﻮﻧ1
؛ﻪﻴﺟﺎﺟز و ﻪﻴﻜﺒﺷ ﭗﻴﺷﻮﻠﻓ و ﻢﺸﭼ ﺺﺼﺨﺘﻣ ﻲﺷزﻮﻣآ هوﺮﮔ رﺎﻳدﺎﺘﺳا
ﻲﺣاﺮﺟ ﻜﺷﺰﭘ هﺪﻜﺸﻧاد ، ﺪﻨﺟﺮﻴﺑ ﻲﻜﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد ،ﻲ
سردآ : ﺪﻨﺟﺮﻴﺑ - يرﺎﻔﻏ نﺎﺑﺎﻴﺧ -
ﻲﻟو نﺎﺘﺳرﺎﻤﻴﺑ ﺮﺼﻋ
) ﺞﻋ ( - ﻢﺸﭼ ﺶﺨﺑ
ﻦﻔﻠﺗ : 9 - 4443001 - 0561 ﺮﺑﺎﻤﻧ : 4442055 - 0561 ﻲﻜﻴﻧوﺮﺘﻜﻟا ﺖﺴﭘ :
؛رﺎﻣآ ﺪﺷرا سﺎﻨﺷرﺎﻛ3
هﺪﻜﺸﻧاد ﻲﻤﻠﻋ تﺄﻴﻫ ﻮﻀﻋ و ﻲﺑﺮﻣ ﻲﻜﺷﺰﭘ
ﺪﻨﺟﺮﻴﺑ ﻲﻜﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد ،
٥٣
ﻪﻣﺪﻘﻣ تﺎﻘﻴﻘﺤﺗ ﻊﻳزﻮﺗ ندﻮﻤﻧ ﻦﺷور ﻪﺑ ردﺎﻗ ﻪﺘﺷﺬﮔ ﻪﻫد ود
ﻧ ﻢﺸﭼ يﺎﻬﻳرﺎﻤﻴﺑ توﺎﻔﺘﻣ ﺸ
ﺖﺳا هﺪ )
1 ( . تﺎﻌﻟﺎﻄﻣ
ﻚﻳژﻮﻟﻮﻴﻣﺪﻴﭘا ﺖﻬﺟ
ﻆﻔﺣ ﻲﺘﻣﻼﺳ و ﻲﻌﻴﺒﻃ ﻲﻳﺎﻨﻴﺑ ،ﻢﺸﭼ
ﻪﻌﻣﺎﺟ رد ﻲﻳﺎﻨﻴﺑ ﻢﻛ و ﻲﻳﺎﻨﻴﺑﺎﻧ زا يﺮﻴﮔﻮﻠﺟ مﺎﺠﻧا
ﻲﻣ ﺷ ﺎﺗ دﻮ
دﻮﻤﻧ ﺎﻋدا ناﻮﺘﺑ ﻲﻳﺎﻨﻴﺑﺎﻧ زا يﺮﻴﮔﻮﻠﺟ ﺖﻬﺟ ﺖﻘﻴﻘﺣ رد ﻪﻛ
مﺎﺠﻧا هدﻮﺑ ﻦﻜﻤﻣ ﻪﭽﻧآ ﺷ
ﺖﺳا هﺪ ) 3،2 .(
داﺪﻌﺗ زا ﻲﻫﺎﮔآ
ﻪﻣﺎﻧﺮﺑ ﺖﻬﺟ ﺎﻬﻧآ يﺮﺘﺴﺑ ﻞﻠﻋ و نارﺎﻤﻴﺑ هدﺎﻔﺘﺳا و يﺰﻳر
مزﻻ تﺎﻧﺎﻜﻣا زا ﺮﺘﻬﺑ ﺖﺳا
ﺑ ﺎﻣا ﻪ تﺎﻋﻼﻃا ﻦﻳا ندروآ ﺖﺳد
فﺮﺻ مﺰﻠﺘﺴﻣ ﻲﻣ ﻪﻨﻳﺰﻫ
ﺪﺷﺎﺑ ؛ ﻦﻴﻨﭼ ﺎﺑ ﻦﻳاﺮﺑﺎﻨﺑ ﻲﻳﺎﻬﻴﺳرﺮﺑ
ﻲﻌﻄﻘﻣ
، ﻲﻣ ناﻮﺗ ار مزﻻ تﺎﻋﻼﻃا ﺑ
ﻪ ﺖﺳد و دروآ
بﺎﺨﺘﻧا ار ﺐﺳﺎﻨﻣ يﺎﻫرﺎﻜﻫار دﻮﻤﻧ
.
نﺎﻣزﺎﺳ شراﺰﮔ سﺎﺳا ﺮﺑ ﻲﻧﺎﻬﺟ ﺖﺷاﺪﻬﺑ
، ﻦﻳﺮﺘﻌﻳﺎﺷ
ﻲﻤﺸﭼ يرﺎﻤﻴﺑ ﺎﻴﻧد رد
ﺖﻛارﺎﺗﺎﻛ ناﻮﻨﻋ ﻪﺑ و
ﻞﻠﻋ ﻪﺣﻮﻟﺮﺳ
يرﻮﻛ ﺎﻫ ) 50 (%
ﻲﻣ ﺪﺷﺎﺑ ﻢﺧاﺮﺗ و ، مﻮﻛﻮﻠﮔ
، ﺲﻳزﺎﻴﻛﺮﺳﻮﻜﻧا ،
و نﺎﻛدﻮﻛ يﺎﻬﻳرﺎﻤﻴﺑ يرﺎﺴﻜﻧا بﻮﻴﻋ
ﻪﺒﺗر رد يﺎﻫ يﺪﻌﺑ
ﺪﻧراد راﺮﻗ )
4 .(
ﻞﻠﻋ و داﺪﻌﺗ ﻦﻴﻴﻌﺗ رﻮﻈﻨﻣ ﻪﺑ ﺮﺿﺎﺣ ﻪﻌﻟﺎﻄﻣ
يﺮﺘﺴﺑ ﻪﺘﺴﺑاو يﺎﻬﻧﺎﺘﺳرﺎﻤﻴﺑ ﻢﺸﭼ ﺶﺨﺑ رد نارﺎﻤﻴﺑ نﺪﺷ
ﺪﺷ مﺎﺠﻧا ﺪﻨﺟﺮﻴﺑ ﻲﻜﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد ﻪﺑ .
شور ﻲﺳرﺮﺑ
،ﻲﻔﻴﺻﻮﺗ ﻪﻌﻟﺎﻄﻣ ﻦﻳارد هﺪﻧوﺮﭘ
ﻲﻣﺎﻤﺗ زا ﻪﻛ ﻲﻧارﺎﻤﻴﺑ
ﺮﻬﻣ هﺎﻣ لﺎﺳ 1373 ﺎﺗ ﺮﻬﻣ هﺎﻣ لﺎﺳ 1380 ﻢﺸﭼ ﺶﺨﺑ رد
يﺎﻬﻧﺎﺘﺳرﺎﻤﻴﺑ ﻲﻜﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد ﻪﺑ ﻪﺘﺴﺑاو
ﺪﻨﺟﺮﻴﺑ
يﺮﺘﺴﺑ ﺷ ﺪﻧدﻮﺑ هﺪ
، ﺪﻨﺘﻓﺮﮔ راﺮﻗ ﻲﺳرﺮﺑ درﻮﻣ .
هﺪﻧوﺮﭘ ﻲﻳﺎﻫ
ﺪﻧﺪﺷ فﺬﺣ ﻪﻌﻟﺎﻄﻣ زا ،ﺪﻧدﻮﺑ ﺺﻗﺎﻧ ﻪﻛ .
لﺎﺣ حﺮﺷ نارﺎﻤﻴﺑ
،
سﺎﺳا ﺮﺑ يرﺎﻤﻴﺑ ﺺﻴﺨﺸﺗ
ICD-10
و ﻦﻴﻨﭽﻤﻫ تﺎﻋﻼﻃا
يدﺮﻓ ) ﻚﻴﻓاﺮﮔﻮﻣد (
نارﺎﻤﻴﺑ ﻪﺑ ﻫ هاﺮﻤ و ﺺﻴﺨﺸﺗ عﻮﻧ
نﺎﻣرد رد ﻪﻣﺎﻨﺸﺳﺮﭘ ﻪﺑ ﻪﻛ يا
ﻫ ﻦﻴﻤ دﻮﺑ هﺪﺷ هدﺎﻣآ رﻮﻈﻨﻣ
،
ﺪﻳدﺮﮔ ﺖﺒﺛ .
ﺮﻈﻧ زا هداد ﻲﮔﺪﻨﻛاﺮﭘ ﺎﻫ
، ﺖﺸﻫ رد نارﺎﻤﻴﺑ
هوﺮﮔ ﻪﻘﺒﻃ ﺮﻳز ﺪﻧﺪﺷ يﺪﻨﺑ :
1 - ﺖﻛارﺎﺗﺎﻛ 2
- مﻮﻛﻮﻠﮔ 3 - ﻲﻳوراد نﺎﻣرد 4
- داﺪﺴﻧا ﻲﻜﺷا ياﺮﺠﻣ
5 - ﻲﻳﺎﺒﻳز لﺎﻤﻋا 6
- ﻪﺑﺮﺿ 7 - ﻲﺤﻄﺳ تاﺮﻴﻴﻐﺗ
ﻪﻤﺤﺘﻠﻣ و ﻪﻴﻧﺮﻗ 8
- ﻜﺒﺷ ﻲﮔرﺎﭘ ﻴ
ﻪ
هداد ﻦﻳا ﻖﻳﺮﻃ زا ﺎﻫ
، عاﻮﻧا ﺺﻴﺨﺸﺗ ﻲﻧاواﺮﻓ ﻊﻳزﻮﺗ
يﺮﺘﺴﺑ يﺎﻬﻳرﺎﻤﻴﺑ هﺪﺷ
، ﺟ نﺎﻣرد عﻮﻧ ﺮ
زا هدﺎﻔﺘﺳا ﺎﺑ ﻲﻳوراد ﺎﻳ ﻲﺣا
ﻞﻴﻠﺤﺗ و ﻪﻳﺰﺠﺗ و ﻲﺑﺎﻳزرا درﻮﻣ ﻲﻔﻴﺻﻮﺗ يرﺎﻣآ يﺎﻬﺷور راﺮﻗ
ﺮﮔ ﺪﻨﺘﻓ .
ﻪﺘﻓﺎﻳ ﺎﻫ
زا 523 يﺮﺘﺴﺑ رﺎﻤﻴﺑ هﺪﺷ
) 543 ﻢﺸﭼ ( ﻢﺸﭼ ﺶﺨﺑ رد ،
5 / 45 % نز و 5 / 54
% دﺮﻣ ﺪﻧدﻮﺑ . نﺎﻧز ﻲﻨﺳ ﻦﻴﮕﻧﺎﻴﻣ 5
/ 61 رد و
نادﺮﻣ 5 / 54 دﻮﺑ لﺎﺳ . ﻦﻳﺮﺘﺸﻴﺑ شﺮﻳﺬﭘ
ﻪﺑ طﻮﺑﺮﻣ ﺑ ﻲﻧارﺎﻤﻴﺑ
دﻮ
ﺪﻨﺘﺷاد ﻲﺣاﺮﺟ ﻞﻤﻋ ﻪﺑ زﺎﻴﻧ ﻪﻛ ﻪﻛ
60 % نﺎﻧآ ﻞﻛ زا )
326 درﻮﻣ (
ﻪﺑ ﻼﺘﺒﻣ ﺖﻛارﺎﺗﺎﻛ
ﺪﻧدﻮﺑ . ﻲﻨﺳ ﻦﻴﮕﻧﺎﻴﻣ نارﺎﻤﻴﺑ ﻦﻳا
رد نﺎﻧز
22 / 68 رد و نادﺮﻣ 75 / 66 لﺎﺳ دﻮﺑ .
ﻪﺑﺮﺿ ﻢﺸﭼ ﻪﺑ ﺑ
ﻪ ﻲﻠﻛ رﻮﻃ رد
6 / 11
% نارﺎﻤﻴﺑ زا دﻮﺟو
ﺖﺷاد و ﻞﻣﺎﺷ ﻲﻣﺎﻤﺗ ﻲﻧارﺎﻤﻴﺑ دﻮﺑ
ﻢﺸﭼ ﻪﺑ ﻪﻣﺪﺻ ﺖﻠﻋ ﻪﺑ ﻪﻛ
ﺪﻧدﻮﺑ هﺪﺷ يﺮﺘﺴﺑ )
و ﻪﻴﻧﺮﻗ و ﻪﻤﺤﺘﻠﻣ ﻚﻠﭘ يﺎﻬﻴﮔرﺎﭘ زا ﻢﻋا
اﺮﻠﻜﺳا ( ﻦﻴﻨﭽﻤﻫ ؛ ﺑ ﻪﻤﻫ
ﻴ نارﺎﻤ وا ژ ﺖﺷادﺮﺑ رد ار ﺲﻧا .
داﺪﻌﺗ
ﻪﺑﺮﺿ لﺎﺳ رﺎﻬﭼ ﻲﻃ رد ﻢﺸﭼ يﺎﻫ لوا
) زا 73 ﺎﺗ 76 ( ﻪﺑ ﺖﺒﺴﻧ
ﺎﻬﭼ ﺪﻌﺑ لﺎﺳ ر )
زا 77 ﺎﺗ 80 ( زا 31 ﺮﻔﻧ ﻪﺑ 26 ﺖﺷاد ﺶﻫﺎﻛ ﺮﻔﻧ .
دراﻮﻣ ﻪﻴﻜﺒﺷ ﻲﮔرﺎﭘ 3
/ 3
% ) 18 ﺮﻔﻧ ( دﻮﺑ نارﺎﻤﻴﺑ ﻦﻳا ﻦﻴﺑ رد .
دﺎﺣ مﻮﻛﻮﻠﮔ ﻪﺑ ﻼﺘﺒﻣ نارﺎﻤﻴﺑ داﺪﻌﺗ 7
/ 3 )%
20 ﺮﻔﻧ ( دﻮﺑ . رد
ﻲﺣاﺮﺟ لﺎﻤﻋا ﺮﻳﺎﺳ ﻦﻴﺑ
، ﻲﻜﺷا يرﺎﺠﻣ داﺪﺴﻧا 2
) % 11 ﺮﻔﻧ (
دﻮﺑ هداد صﺎﺼﺘﺧا دﻮﺧ ﻪﺑ ار دراﻮﻣ ﻪﻛ
ﻦﺳ 2 ﺮﻔﻧ ﺎﻬﻧآ زا ﺮﻳز 2
زا ﺮﺘﺸﻴﺑ ﻪﻴﻘﺑ و لﺎﺳ 2
لﺎﺳ دﻮﺑ .
وﺮﺘﻛا ﻞﻣﺎﺷ ﻲﻳﺎﺒﻳز ﻲﺣاﺮﺟ لﺎﻤﻋا ﻮﻴﭘ
،ن آﻧ ﻴﭘوﺮﺘ ﻮ
،ن
ﻮﺗ و ﻢﺴﻴﺑاﺮﺘﺳا رﻮﻣ
ﻚﻠﭘ يﺎﻫ دوﺪﺣ
1 / 3
% ) 17 ﺮﻔﻧ ( دﻮﺑ .
ﺗ ﺮﻧژد ﻞﻣﺎﺷ ﻲﺤﻄﺳ تاﺮﻴﻴﻐ ﺲﻧﺎﺳ
ﺎﻫ زا ﻪﻤﺤﺘﻠﻣ و ﻪﻴﻧﺮﻗ ي
د ﻪﻠﻤﺟ ژ ر عﻮﻤﺠﻣ رد يزﻼﭘﻮﻜﻟ و لاﺪﻴﺋوﺮﻔﺳا ﺲﻧﺎﺳ 9
/ 0 ) % 5
ﺮﻔﻧ ( دﻮﺑ . نﺎﻤﻫ ﻪﻛ رﻮﻃ ﺷا
ﺎ ﺪﺷ هر ﺮﺘﺸﻴﺑ ﻲﻧارﺎﻤﻴﺑ ﺶﺨﺑ رد ﻪﻛ
ﻢﺸﭼ
هﺪﺷ يﺮﺘﺴﺑ ﺪﻧدﻮﺑ
، ﻋا ﻪﺑ زﺎﻴﻧ ﻤ ﺎ ل ﻲﺣاﺮﺟ ﻪﺘﺷاد ﺎﻬﻨﺗ و ﺪﻧا 3
/ 7
% زا
٥٤ نارﺎﻤﻴﺑ ) ﻞﻴﺒﻗ زا يدراﻮﻣ ﺖﻴﺗاﺮﻛ
، او ﺖﻴﺋ
، ا ﺖﻴﻟﻮﻠﺳ رو
و ﺖﻴﺑ
ﻓوﺪﻧآ ﺖﻴﻤﻟﺎﺘ ( ﻪﺘﻓﺮﮔ راﺮﻗ ﻲﻳوراد نﺎﻣرد ﺖﺤﺗ ﺪﻧدﻮﺑ
ﻪﻛ زا
ﻦﻴﺑ ﺎﻬﻧآ درﻮﻣ ﻦﻳﺮﺘﺸﻴﺑ ﻛ
ﺖﻴﺗاﺮ ) 3 / 3
% ( ﻦﻳﺮﺘﻤﻛ و درﻮﻣ
) 5 / 0
% ( دﻮﺑ ﺖﻴﻤﻟﺎﺘﻓوﺪﻧآ .
ﺚﺤﺑ
،ﻖﻴﻘﺤﺗ ﻦﻳا رد ﺮﺘﺸﻴﺑ
يﺮﺘﺴﺑ نارﺎﻤﻴﺑ هﺪﺷ
، ﻪﺑ ﻼﺘﺒﻣ
ﺖﻛارﺎﺗﺎﻛ دﻮﺑ
ﻧ ﺪ
؛ عﻮﻴﺷ ﻦﻳا ﺎﺑ ﻻﺎﺑ
ﻪﻌﻟﺎﻄﻣ ﺞﻳﺎﺘﻧ
Cruciani
و
نارﺎﻜﻤﻫ )
5 ( ﻲﻧاﻮﺨﻤﻫ دراد
؛ ﻪﻌﻟﺎﻄﻣ رد
Mulla
و
Margo
رد ﻪﻛ ﻪﺑﺮﺿ ﺮﻴﻏ نارﺎﻤﻴﺑ ﻦﻴﺑ ا نﺎﺘﺳرﺎﻤﻴﺑ رد يا
مﺎﺠﻧ ﺪﺷ
،
يﺮﺘﺴﺑ نارﺎﻤﻴﺑ ﻦﻳﺮﺘﺸﻴﺑ ﺎﻳ ﻲﻧﻮﻔﻋ يﺎﻬﻳرﺎﻤﻴﺑ رﺎﭼد هﺪﺷ
ﻮﻟﻮﻤﻟﺎﺘﻓاورﻮﻧ ژ
ﺪﻧدﻮﺑ ي ) 6 .(
ﻦﻳﺮﺘﺸﻴﺑ ﺎﻴﻧد رد يرﻮﻛ ﻞﻠﻋ ﺖﻛارﺎﺗﺎﻛ ﺖﻠﻋ ﻪﺑ
شراﺰﮔ
ﺖﺳا هﺪﺷ ﻪﺑ و
ﻫ ﺰﺟ ﻪﻛ ﺖﺳا ﻞﻴﻟد ﻦﻴﻤ و
رد ﺖﻳﻮﻟوا ﻦﻴﻟوا
ﻮﻛ زا يﺮﻴﮕﺸﻴﭘ ﻞﺑﺎﻗ يﺎﻬﻳرﺎﻤﻴﺑ ﻦﻴﺑ ﻖﻳﺮﻃ زا ير
نﺎﻣزﺎﺳ
ﺗ درﻮﻣ ﻲﻧﺎﻬﺟ ﺖﺷاﺪﻬﺑ ﺄ
ﻛ ﺖﺳا ﻪﺘﻓﺮﮔ راﺮﻗ ﺪﻴ )
7
، 4 .(
دﻮﺑ هﺪﺷ يﺮﺘﺴﺑ نارﺎﻤﻴﺑ ﻦﻴﺑ رد مود مﺎﻘﻣ رد مﻮﻛﻮﻠﮔ .
يﺮﺘﺴﺑ نارﺎﻤﻴﺑ ﻦﻴﺑ زا زوﺮﺑ هﺪﺷ
2 ﺖﻴﻤﻟﺎﺘﻓوﺪﻧآ درﻮﻣ
ﺪﺷ هﺪﻫﺎﺸﻣ ﻪﻛ
ﺎﺑ ﻪﺴﻳﺎﻘﻣ رد شراﺰﮔ
BenEzra
) 072 / 0 (
) 8 ( ﺖﺷاد يﺮﺘﺸﻴﺑ عﻮﻴﺷ .
رد 1 زا درﻮﻣ ﺑﻴ ﻪﻛ ﻲﻧارﺎﻤ ﺖﻬﺟ
ﻲﻳوراد نﺎﻣرد ﺪﺷ يﺮﺘﺴﺑ
دﻮﺑ ه ﺪﻧ
، اﺮﻛ و ﻲﭼرﺎﻗ ﺖﻴﺗ 2
درﻮﻣ
ﺖﻴﻟﺎﺘﻓوﺪﻧآ
؛ﺖﺷاد دﻮﺟو دراﻮﻣ ﺮﻳﺎﺳ
ﻞﻣﺎﺷ اﺮﻛ ﺗ
،ﺖﻴﺋﻮﻳﻮ
ﺖﻴﺑروا ﺖﻴﻟﻮﻠﺳ و
ﻪﻴﻧﺮﻗ يﺎﻫﺮﺴﻟوا ﻦﻴﻨﭽﻤﻫ و
زا يدراﻮﻣ
ﺮﻛاد ﻳ ﻮ ﺖﻴﺘﺴﻴﺳ دﺎﺣ
دﻮﺑ .
ﺖﺒﺴﻧ ﻦﻴﻐﻟﺎﺑ و نﺎﻛدﻮﻛ رد ﻲﻜﺷا ياﺮﺠﻣ داﺪﺴﻧا ﻪﺑ
ﻪﻌﻟﺎﻄﻣ
Lancigo
نارﺎﻜﻤﻫ و )
9 ( ﺖﺷاد يﺮﺘﺸﻴﺑ عﻮﻴﺷ .
ﻦﻴﺑ زا ﻬﺟ ﻪﻛ ﻲﻧارﺎﻤﻴﺑ و ﻚﻠﭘ يﺎﻬﻳرﺎﻤﻴﺑ حﻼﺻا ﺖ
ﺪﺷ يﺮﺘﺴﺑ ﻚﺷا دﻮﺑ ه
ﺪﻧ
، 10 ﺮﺗ درﻮﻣ نﻮﻴﭘوﺮﺘﻧآ ﻢﻴﻣ دﻮﺟو
ﺖﺷاد
؛ رﺎﻣآ ﻦﻳا كﺪﻧا
ﺮﺿﺎﺣ ﻪﻌﻟﺎﻄﻣ ﻲﻣ ﺰﻴﻧ
ﺪﻧاﻮﺗ زا ﻲﺷﺎﻧ
عﺎﺟرا نارﺎﻤﻴﺑ ياراد ﻮﺗ ﻮﻣ ﻪﺘﻓﺮﺸﻴﭘ و ﻊﻴﺳو يﺎﻫر ،
ﺰﻛاﺮﻣ ﻪﺑ
ﻲﺼﺼﺨﺗ قﻮﻓ ﺪﺷﺎﺑ
) 10 .(
ﻦﻴﺑ زا ﻪﺑﺮﺿ ﺎﺑ ﻪﻛ ﻲﻧارﺎﻤﻴﺑ يﺎﻫ
ﺪﺷ يﺮﺘﺴﺑ ﻲﻤﺸﭼ
،ﺪﻧدﻮﺑ ه د
ر 3 درﻮﻣ ﻞﻴﻟد ﻪﺑ ﻲﻤﺸﭼ تﺎﺣاﺮﺟ
ﺪﻳﺪﺷ دﻮﺑ هﺪﺷ مﺎﺠﻧا ﻢﺸﭼ ﻪﻴﻠﺨﺗ ، .
ﺞﻳﺎﺘﻧ نﺎﺸﻧ ﻪﻌﻟﺎﻄﻣ ﻦﻳا داد
ﻪﻛ ﻪﺑﺮﺿ ناﺰﻴﻣ رد ﻢﺸﭼ يﺎﻫ
ﺮﻴﺧا يﺎﻬﻟﺎﺳ ﺖﺳا ﻪﺘﻓﺎﻳ ﺶﻫﺎﻛ
ﻪﻛ
ًﻻﺎﻤﺘﺣا زا يﺮﻴﮕﺸﻴﭘ ﻪﺑ ﻪﺟﻮﺗ ﺎﺑ ﺖﻴﻌﻤﺟ ﺶﻳاﺰﻓا
ﺖﻴﻤﻫا ﺰﺋﺎﺣ
ﻲﻣ ﻪﺘﻓﺎﻳ ﻦﻳا ؛ﺪﺷﺎﺑ شراﺰﮔ ﺎﺑ
و Nash Morgo
) 11 ( سﺎﺳا ﺮﺑ
نﺎﻣزﺎﺳ زا ﻲﻧﺎﻬﺟ ﺖﺷاﺪﻬﺑ تﺎﻌﻟﺎﻄﻣ رادرﻮﺧﺮﺑ يﺮﻴﮕﻤﺸﭼ توﺎﻔﺗ
دﻮﺑ . ﻪﺑ زﺎﻴﻧ ﻪﻛ ﻪﻤﺤﺘﻠﻣ و ﻪﻴﻧﺮﻗ ﻲﺤﻄﺳ تاﺮﻴﻴﻐﺗ ﺘﺴﺑ
ﺪﻨﺘﺷاد يﺮ
،
ﺮﺘﻤﻛ و دﻮﺒﻧ رادرﻮﺧﺮﺑ ﻲﻳﻻﺎﺑ ﺪﺻرد زا ﺮﻳﺬﭘ ﻦﻳ
ﺖﺷاد ار ش .
ﺎﻬﻨﺗ ﻪﻴﻜﺒﺷ ﻲﮔﺪﺷاﺪﺟ ﻞﻣﺎﺷ
3 / 3 % هﺪﺷ يﺮﺘﺴﺑ نارﺎﻤﻴﺑ زا دﻮﺑ
.
شراﺰﮔ دراﻮﻣ ي ﻠﺧ ﻲﮔرﺎﭘ رﺎﭼد ﻪﻛ ﻲﻔ
ﻳ و ﻪﻴﻜﺒﺷ تاﺮﻴﻴﻐﺗ ﺎ
ﺪﻧدﻮﺑ ﻮﻴﺗاﺮﻔﻴﻟوﺮﭘ
، ﺑ ﻪ ماﺰﻋا ﻞﻴﻟد ﺰﻛاﺮﻣ ﻪﺑ
ﺮﺗﺰﻬﺠﻣ
، دﻮﺒﻧ ﻦﻜﻤﻣ
) 12 .(
تﺎﻋﻼﻃا ﺮﺿﺎﺣ ﻖﻴﻘﺤﺗ
ﻪﺑ ﻼﺘﺒﻣ نارﺎﻤﻴﺑ ﺖﻤﺴﻗ رد
ﻪﺑ ﺮﺼﺤﻨﻣ ﻪﻴﻜﺒﺷ ﻲﮔﺪﺷاﺪﺟ 4
و لﺎﺳ نارﺎﻤﻴﺑ سﺎﺳا ﺮﺑ
يﺮﺘﺴﺑ ﻲﻣ راﻮﺘﺳا هﺪﺷ ﺪﺷﺎﺑ
ﻞﻴﻟد ﻦﻴﻤﻫ ﻪﺑ ؛ ﺖﺳا ﻦﻜﻤﻣ
اواﺮﻓ ﻧ ﻲ
ﺪﺷﺎﺑ ﻦﻳا زا ﺮﺘﺸﻴﺑ ﻲﻌﻗاو .
وWong
نارﺎﻜﻤﻫ ﻪﻧﻻﺎﺳ زوﺮﺑ ناﺰﻴﻣ
ﻪﻴﻜﺒﺷ ﻲﮔﺪﺷ اﺪﺟ رد
رﻮﭘﺎﮕﻨﺳ ار
5 / 10 ﺖﻴﻌﻤﺟ راﺰﻫ ﺪﺻ ﺮﻫ يازا رد ﺪﻧدﺮﻛ شراﺰﮔ
) 13 ( رد ﻪﻛ ﻪﻘﻄﻨﻣ ﺎﻣ ﻪﻌﻟﺎﻄﻣ درﻮﻣ يﺮﺘﻤﻛ عﻮﻴﺷ
؛ﺖﺷاد دﻮﺟو
كﻼﻣ ﻪﺘﺒﻟا ﺎﻬﻴﺳرﺮﺑ ﻦﻳا رد نارﺎﻤﻴﺑ دورو ﻂﻳاﺮﺷ ﻲﺼﻴﺨﺸﺗ يﺎﻫ
ﺑ ﻪﺴﻳﺎﻘﻣ نﺎﻜﻣا ﻪ
ﻲﻤﻧ ﻦﻜﻤﻣ ار ﻲﻌﻗاو ترﻮﺻ ﺪﻳﺎﻤﻧ
.
زا ﻪﺘﻓﺎﻳ ﻦﻳﺮﺘﻤﻬﻣ ﻪﻌﻟﺎﻄﻣ ﻦﻳا يﺎﻫ
، صﺎﺼﺘﺧا ﺮﺘﺸﻴﺑ
نارﺎﻤﻴﺑ
دﻮﺑ ﺖﻛارﺎﺗﺎﻛ ﻪﺑ .
ناﺮﮕﻳد تﺎﻌﻟﺎﻄﻣ ﺎﺑ ﻪﺴﻳﺎﻘﻣ رد ﺖﻴﻤﻟﺎﺘﻓوﺪﻧآ زوﺮﺑ
ﺖﺷاد يﺮﺘﺸﻴﺑ عﻮﻴﺷ ﻦﻳاﺮﺑﺎﻨﺑ ؛
ﻲﻣ ﻪﻴﺻﻮﺗ يﺮﺘﺸﻴﺑ تﺎﻌﻟﺎﻄﻣ ددﺮﮔ
ﺑ ﻪﻘﻄﻨﻣ ﻦﻳا رد ﺖﻛارﺎﺗﺎﻛ زﺎﺳﺮﻄﺧ ﻞﻣاﻮﻋ ﻲﺳرﺮﺑ ﺖﻬﺟ ﻪ
ﻞﻤﻋ
ﺪﻳآ . ﺮﻜﺸﺗ و ﺮﻳﺪﻘﺗ
ﺘﺤﻣ نﺎﻨﻛرﺎﻛ زا ﻢﺸﭼ ﺶﺨﺑ مﺮ
ﻖﻴﻘﺤﺗ ﻦﻳا مﺎﺠﻧا رد ﻪﻛ
ﻲﻣ ﻲﻧادرﺪﻗ و ﺮﻜﺸﺗ ،ﺪﻧدﻮﻤﻧ يرﺎﻜﻤﻫ ﻪﻧﺎﻤﻴﻤﺻ ددﺮﮔ
.
ﻊﺑﺎﻨﻣ :
٥٥
1- Willson MR. Epidemiology in Ophthalmology. Arch Ophthalmol 2001; 119 (9) :1374-75.
2- Vaghan D, Asbury T, Riordan-Eva P. General Ophthalmology. 15th ed. USA: Appleton & Lange; 1999: 270.
3- Jonson GJ, Minassian DC, Weale R. The Epidemiology of Eye Disease .USA: Appleton & Lange; 1998: 6.
4- Catherine A, Mc Carty, Hugh R, Tylor. Myopia and vision 2020. 2000; 4 (129): 525-27.
5- Cruciani F, Lombardo E, Abdolrahimzadeh B, Antonelli B, Saracino V, Melino G., Recent trends of ophthalmic diseases in Italy: are official data reliable? Clin Ter. 2002; 153 (4): 251-55.
6- Mulla ZD, Margo CE, Hospitalization for nontraumatic disorders of the eye and ocular adnexa: analysis of the Florida agency for health care administration data set. Arch Ophthalmol 2004; 122 (2): 262-66.
7- Thylefors B. A global initiative for the elimination of avoidable blindness. Am J Ophtamol 1998; 125 (1): 90-93.
8- BenEzra D.Ocular Inflammation, Basic and Clinical Concepts. London: Martin Dunitz; 1999: 277.
9- Lanciego C, De Miguel S, Perea M, Cano C, Garcia IR, Davila J, et al. Nasolacrimal stent in the management of epiphora: medium-term results of multicenter prospective study. J Vasc Interv Radiol 2001; 12 (6): 701-10.
10- Albert DM. Ophthalmic Surgery, Principles and Techniques. Vol 2. London: Black Well Science; 1999: 1189-98.
11- Nash EA, Morgo CE. Patterns of emergency department visits for disorders of the eye and ocular adnexa. Arch Ophthalmol 1998; 116 (9): 1222-26.
12- Han DP, Mohsin NC, Guse CE, Hartz A, Tarkanian CN. Comparision of pneumatic retinopexy and scleral buckling in the management of primary rhegmatogenous retinal detachment. Am J Ophtamol 1998; 126 (5): 658-68.
13- Wong TY, Tielsh JM, Schein OD. Racial difference in the incidence of retinal detachment in Singapor. Arch Ophthalmol 1999; 117 (3): 379- 83.
٥٦
Prevalence of ophthalmic problems in Birjand hospitals (1994-2001)
Gh. Yaqubi*, SM. Hosseini**
* Assistant Professor, Vitreoretinal Fellowship, Department of Ophthalmology, Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran
** MSc in Biostatistics, Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran
Abstract
Background and Aim: Information on the causes of hospitalization is essential to plan a better use of resources .According to certain hospital and WHO records cataract is the most important cause of blindness (%50) in the world. So, this study was conducted to determine the prevalence of eye disease among Imam-Reza hospital clients.
Materials and Methods: In this retrospective study hospitalized clients in ophthalmology center of Birjand Imam-Reza hospital were assessed (1994-2001). Data were collected from patients’ files.
These data included demographic information, medical diagnoses and other necessary data which were recorded in ICD-10 in a questionnaire and because the data was scattered very much it was collected in 8 categories and then analyzed.
Results: The findings of this study showed that 523 patients were hospitalized (for 543 eye problems). Of these 45.5% were females and 54.5% were males. Eye surgery was the most important reason for hospitalization and among eye diseases cataract was the most prevalent (60%).
Glaucoma was 3.7% and had more complications than cataract. Medical treatment was administrated to 7.3% of patients. Except two cases of endophthalmitis, which occurs after cataract surgery and one fungal keratitis, other cases responded to medical treatment.2.6% of patients had nasolacrimal duct obstruction and 3.1% underwent plastic surgery.11.6%had eye trauma and 303%
had retinal detachment.
Conclusion: This study allowed to estimate the burden of hospitalization and the cause of admission considering priority. In this study we did not have retinal detachment after cataract surgery but exogenous endophthalmitis was higher in our patients .Ocular trauma has noticeably reduced in recent years. The most common cause of hospitalization was cataract; so it is necessary to do another survey to determine possible risk factors in clients suffering from cataract.
Key Words: Epidemiology; Ophthalmic diseases; Hospital; ICD-10
