早产儿视网膜病变的临床分析

Clinical Analysis of Retinopathy of Prematurity

目的探讨不同体质量早产儿视网膜病变的发病率、临床分期、治疗和转归。方法回顾性分析南昌大学第二附属医院2007年11月-2009年1月两年儿童眼科门诊筛查的106例早产儿,对其中出现视网膜病变的16例进行综合分析。结果在106例早产儿中,发病16例。其中体质量1000～1500g组发病7例,体质量1501～2000g组发病6例,体质量2001～2500g组发病2例,体质量2501～2800g组发病1例。有5例5期病变,1例4期病变,6例2期病变,4例1期病变,均有出生后给氧史。5期患儿愈后差,4期患儿早期手术,存留一部分视力,1例2期患儿发展至3期,及时行视网膜激光治疗,愈后好,余2期1期患儿经随访均视网膜完全血管化。结论早产儿视网膜病变的发病随出生体重的增加而减少,随出生时吸氧的浓度和时间增加而增加。早检查、早发现、早治疗是预防早产儿视网膜病变致盲的重要措施。

Objective To explore the incidence of retinopathy, clinical stages, treatment and prognosis in premature infants with various body weight. Methods The records of 106 premature infants,who participated eyeground screening in the out-patient department of our hospital during past two years, were retrospectively investigated. 16 cases of retinopathy were found, and were subjected to a package of analysis based on birth weight, history of oxygen uptake,and clinical stages. Results 7 premature infants whose birth weight ranged from 1 000 to 1 500 g were cases of retinopathy;6 premature infants whose birth weight ranged from 1,501 to 2,000 g were cases of retinopathy;2 premature infants whose birth weight ranged from 2,001 to 2,500 g were cases of retinopathy;1 premature infants whose birth weight ranged from 2,501 to 2,800 g were cases of retinopathy. According to clinical stages,there were 5 cases of 5 lesions, 1 case of 3 lesions,6 cases of 2 lesions,4 cases of 1 lesion. They all had the history of oxygen uptake after birth. 1 case of 5 lesions and a case of 4 lesions had poor prognosis. 1 case whose lesion developed from 2 to 3 had effective treatment of retinal laser. The other cases＇s retina was fully vascularized. Conclusion The incidence of retinopathy is negatively correlated with birth weight, and is positively correlated with the length of oxygen uptake and its levels. Early inspection, early detection and early treatment are of importance in preventing blinding caused by retinopathy in premature infants.