早产儿视网膜病变的筛查与高危因素分析

Clinical analysis ofretinopathy of prematurity

目的研究早产儿视网膜病变（ROP）发病情况及相关的危险因素，探讨其合理的筛查标准。方法对出生体重≤2500g，胎龄≤37周患儿进行ROP筛查，并行相关因素分析。结果共筛查275例符合条件的早产儿，发现ROP38例（13．82％）；出生体重≤1500g组，～2000g组，～2500g组患病百分比有显著性差异（P〈0．05）；出生胎龄≤30周组，-32周组，≥33周组间ROP患病百分比有显著性差异（P〈0．05）；ROP早产儿的吸氧时间明显高于无ROP组（Z=5．292，P=0．000），需要机械辅助呼吸的早产儿发生ROP者较多（χ^2=30．597，P=0．000），多胎与单胎间发生ROP的差异无统计学意义（χ^2=0．748，P=0．387），ROP发病与出生胎龄、出生体重、吸氧时间、机械辅助呼口等因素相关。结论出生体重越低，出生胎龄越小，吸氧时间较长，需要机械辅助呼吸的早产儿，ROP患病率越高。早产儿应及时检查眼底，尽早发现ROP。

Objective To observe the prevalence and the risk factors of retinopathy of prematurity （ROP）in premature and low birth weight infants and to investigate the reasonable ROP screening standard methods.Methods Totally 275 premature infants who were less than 37weeks postconceptional age, or birth weight ≤ 2500g who were treated in our hospital.They were screened for ROP until the retina was entirely vascularised.Results The prevalence of ROP in our study was 13.82%, the prevalence of ROP in subgroup with birth weight ≤ 1500g （37.84%）was significantly higher than the subgroup with birth weight 1501-2000g （ 8.06% ）and the subgroup with birth weight 2001-2500g （ 2.24% ） （ χ^2 = 45.357, P= 0.000 ）.There were significant difference in ROP rate among group （gestional age≤ 30 weeks）,group （gestional age 31-32 weeks）and group （gestional age〉 33 weeks） （P= 0.000）.ROP infants had longer time of oxgen supplementation （ χ^2= 5.292, P= 0.000 ）and more demand of mechanical ventilation （ χ^2= 30.597, P= 0.000 ）.Cases with multiple gestational births in ROP group were not significantly different from that in non-ROP group （χ^2 =0.748,P = 0.387）.ROP was related to gestational age, birth weight, oxygen duration time and the using mechanical ventilation.Conclusion Shorter gestational age and lower birth weight and less time of giving oxygen and the using mechanical ventilation may result in higer ROP incidence.Routine screening of fundus in premature infants may be helpful for the early detection of ROP.