早产儿视网膜病变的筛查结果分析

Clinical analysis of retinopathy of prematurity

目的：总结早产儿视网膜病变（retinopathy of prematurity，ROP）发生发展特点及相关危险因素，探讨其合理的筛查标准和治疗模式。方法：对胎龄≤35wk，体质量≤2500g的1626例早产儿进行ROP筛查，并对其临床特点进行总结。结果：发现ROP173例（10．64％）；出生体质量≤1000g组，1001～1500g组，1501～2000g组，2001～2500g组患病百分比有显著性差异（分别为89．64％，29．71％，7．82％，1．29％，P〈0．05）；出生胎龄≤30wk组，30wk〈出生胎龄≤32wk组，32wk〈出生胎龄≤35wk组间ROP患病百分比有显著性差异（分别为31．11％，12．24％，4．04％，P〈0．05）；单生子与多生子患病率有显著性差异（分别为6．99％，34．12％，P〈0．05）；少数全身病情严重者可在32wk前发生ROP；患儿行冷凝术36例，手术效果满意。结论：体质量〈1500g，胎龄〈31wk，多生子中发病率高；及早行冷冻术病情榨制满意。

AIM： To observe the occurrence and progress of retinopathy of prematurity （ROP） in premature and low birth weight infants and search the reasonable ROP screening standard and therapeutic methods. METHODS： ROP screening was carried out under indirect ophthalmoscope in 1626 premature infants （gestational age≤35 weeks, birth weight≤2500g） who were treated in our neonatal department. Their clinical characteristics were xummarized. RESTULTS： 1 ） ROP was found in 173 infants （10.4%）; 2） There was significant difference in ROP rate among group（ ≤1 000g）, group（1 001-1 500g）, group（1 501-2000g）, and group（2001-2505g） （P 〈 0.05） ; 3） There was significant difference in ROP rate among group （gestational age ≤ 30 weeks）, group（gestational age 31-32weeks）, and group （gestational age 33-35 weeks） （ P 〈 0.05 ） ; 4） There was significant difference between single-birth infants group and multiple-birth infants group （P〈0.05） ; 5） ROP could be found in the infants with severe systemic diseases earlier than 32 weeks; 6） Thirty-six infants underwent cryosurgery and got satisfactory outcomes. CONCLUSION： The ROP incidence was higher in the premature infants （multiple-birth infants, birth weigh lower than 1 500g , gestational age less than 32 weeks） ; ROP screening should be done much earlier in some severe infants; timely cryosurgery in progressive or severe ROP cases will lead to good prognosis.