早产儿视网膜病手术后呼吸暂停临床分析

Clinical analysis of apnea after operation for retinopathy of prematurity

目的回顾性分析早产儿视网膜病(ROP)手术后患儿呼吸暂停的发病情况。方法收集因ROP接受手术治疗早产儿(ROP组)和同期收治的无ROP等原发疾病早产儿(对照组,n=23)的临床资料。记录ROP组术后及对照组校正胎龄37周时的呼吸暂停发生情况(包括发生时间、缓解情况及原发疾病等);共随访4周,比较两组呼吸暂停发病率。结果ROP组17例早产儿中发生呼吸暂停9例(占52.9%),对照组23例早产儿中发生呼吸暂停5例(占21.7%),两组呼吸暂停发生率比较差异有统计学意义(P<0.05)。ROP组呼吸暂停发生时间为术后(38±40)h,缓解时间为发生后(126±145)h;发生术后呼吸暂停患儿中,肺炎3例(33.3%),低血糖1例(11.1%),原因不明5例(55.5%)。结论接受ROP手术早产儿术后容易发生呼吸暂停。为确保手术前后患儿生命体征平稳,专科和儿科医师有必要共同参与围手术期的监护。

Objective To retrospectively explore the incidence and causes of apnea after operation for retinopathy of prematurity （ROP）. Methods The clinical data of 17 premature infants with operation for ROP （ ROP group） and the other 23 premature infants without ROP （control group） were collected. The occurrence of apnea （time of onset and remission and original diseases） was recorded after operation in ROP group and at adjusted 37 weeks of gestational age in control group. Follow-up was conducted for 4 weeks, and the prevalences of apnea were compared between these two groups. Results There was significant difference in prevalcnces of apnea between ROP group and control group （52.9% vs 21.7%, P 〈 0.05）. In ROP group, time of occurrence of apnea was （38 ± 40） h after operation, and time of remission was （126 ± 145） h after onset. Among the infants with apnea, there were 3 cases of pneumonia （33. 3%）, 1 case of hypoglycemia （ 11.1% ） and 5 cases with unexplained causes （55.5 % ）. Conclusion Infants after operation for ROP are more prone to apnea, and pediatricians and ophthalmologists are required to collaborate in the perioperative care.