床旁激光治疗早产儿视网膜病变的疗效分析

Bedside treatment of retinopathy of premeturity by laser photocoagulation

目的探讨床旁激光治疗早产儿视网膜病变(ROP)的临床效果。方法回顾性分析2009年3月至2009年8月在我院新生儿重症监护室(NICU)内床旁激光治疗的30例ROP患儿的临床资料。结果 30例ROP患儿中59只眼接受了激光治疗,总体治愈率95%。根据ROP国际分类标准,30例ROP患儿中,Ⅰ区病变有13例(26眼),Ⅱ区病变有17例(33眼)。Ⅰ区病变组平均出生胎龄、体重及治疗时纠正胎龄均明显低于Ⅱ区病变组,而激光斑点数量明显高于Ⅱ区病变组。Ⅱ区病变组治愈率(100%)明显高于Ⅰ区病变组(88%)(P<0.05)。结论 NICU床边激光手术治疗Ⅰ区病变和Ⅱ区病变是有效的。与Ⅱ区病变相比,Ⅰ区病变患儿预后相对较差。

Objective To study the efficacy of bedside treatment by laser photocoagulation for retinopathy of prematurity （ROP） in preterm infants hospitalized in the Neonatal Intensive Care Unit （NICU）.Methods The clinical data of 30 cases of ROP who underwent peripheral laser ablation on bedside in the NICU from March to August 2009 were studied retrospectively.Results A total of 59 eyes from 30 patients received the laser therapy,with a total cure rate of 95%.According to the International Classification of ROP,26 eyes of 13 infants had zone 1 disease,and 33 eyes of 17 infants had zone 2 disease.The birth gestational age and birth weight as well as corrected gestational age and corrected weight at operation in the zone 1 disease group were significantly lower than those in the zone 2 disease group.The number of laser spots in the zone 1 disease group was significantly higher than that in the zone 2 disease group.The cure rate in the zone 2 disease group （100%） was significantly higher than that in the zone 1 disease group （88%）.Conclusions Laser retinal photocoagulation on bedside in the NICU is effective for both zone 1 and zone 2 ROP.As compared with the infants with zone 2 disease,the infants with zone 1 disease may have a poor outcome.