早产儿视网膜病激光治疗及相关危险因素研究

Study on risk factors and laser therapy for retinopathy of prematurity

目的探讨早产儿视网膜病(retinopathy of prematurity,ROP)激光治疗效果及该病发生的相关危险因素。方法以35例因各种疾病住院治疗的早产儿为观察对象。对性别、胎龄、出生体重、Apgar评分、出生时及出生后缺氧、贫血、黄疸、感染、母亲年龄及孕期情况进行观察并进行头颅B超检查。用χ2检验、Fisher确切概率法、t检验以及Logistic回归做统计分析,评价激光治疗的疗效,分析早产儿视网膜病发生的危险因素。结果35例患病早产儿中有27例发生早产儿视网膜病,发生率77.1%。25例患儿接受激光治疗,并分别于术后7～14d及3个月进行随访,治愈率分别为74.1%和92.6%。ROP组出生体重(1144.81±284.83)g,明显小于未发病组(8例)出生体重(1743.75±423.79)g,P<0.01;ROP组胎龄(29.04±2.70)周,明显小于未发病组胎龄(32.50±1.85)周,P<0.01。且出生体重越低,胎龄越小,ROP发生率越高,P<0.01。经Fisher确切概率法检验显示出生后缺氧、贫血等因素在ROP发病组与未发病组差异有统计学意义(P<0.05)。结论早产儿视网膜病在伴随各种疾病的早产儿中发生率较常见患病率高,其发病与缺氧、贫血、胎龄和出生体重有关。对患病早产儿进行激光治疗可获得较好的疗效,采取早监测、早发现、早治疗,则可获得较好的预后。

Objective To investigate the risk factors for retinopathy of prematurity （ROP） and outcome of laser therapy. Methods Thirty five preterm infants with various diseases in hospital were observed and the factors （sex, gestational age, birth weight, Apgar score, antenatal and postnatal hypoxia, anemia, jaundice, infection, mother＇s age and pregnant circumstance, ultrasonic inspection on head） were studied. Risk factors and laser therapy outcome were analyzed by univariate analysis and logistic regression model. Results Twenty-seven of 35 infants（77.1%） were diagnosed as ROP. Twenty five infants were treated by laser and follow-up twice （between 7 to 14 days and 3 month after laser therapy） with the recovery rate 74.1 %and 92.6 %, respectively. In ROP group, the birth weight （1144.8±284.83 g）, gestational age （29.04 ± 2.70 weeks） were lower than non ROP group（P〈0.01）. Postnatal hypoxia and anemia were also the risk factors for ROP. Conclusions Birth weight, gestational age, postnatal hypoxia and anemia were the risk factors for ROP. ROP infants may be benefit from the laser therapy with early diagnosis and early treatment.