目的：探索适合本地实际情况的屈光发育档案管理模式。方法：总结本区屈光发育档案推行数据，采用鱼骨图系统分析影响屈光发育档案在基层医院推行的关键因素。结果：影响屈光发育档案在基层医院推行的关键因素包括家庭因素、个人因素、学校因素、医院因素。建议通过与学校加强合作，进行健康教育，加强与学生、家长的沟通，开发简易技术，加强医院信息化建设，逐步建立适合本地实际情况的屈光发育档案管理模式。结论：在基层医院建立青少年屈光发育档案受多种因素影响，需平衡家庭、学校、医院的关系，加强数字化平台建设。

Objective: To explore an appropriate management model of refractive development archives suitable for local conditions. Methods: The main influencing factors of refractive development archives in primary hospitals were analyzed by using fishbone diagram. Results: The influencing factors included family factors, personal behavior, school and medical factors. It was recommended to improve the cooperation with school and strengthen communication with students and parents. The hospital should develop simple technologies to strengthen the construction of information technology. An appropriate model of refractive development archives was established according to the local situation. Conclusion: The establishment of adolescent refractive development archives in primary hospitals is affected by many factors. It is necessary to balance the relationship among families, schools and hospitals, and strengthen the construction of digital platforms.