多生子早产儿视网膜病变的临床特点

Clinic analysis of retinopathy of prematurity in multiple infants

目的观察多生子早产儿视网膜病变(ROP)的发生发展特点,探讨影响ROP发生发展的相关因素。方法对湖南省儿童医院新生儿科及眼科2006年4月至2011年4月收治的胎龄<35周,体重<2000 g的早产儿在出生后2周开始采用间接眼底镜及巩膜压迫器观察视网膜。根据早产儿视网膜病变国际分类法分期记录ROP病变,同时记录患儿全身疾病并发情况,观察及分析多生子与单生子中ROP发生的临床特点及相关因素。结果共筛查33 049例胎龄<35周,体重<2000 g的早产儿,其中单生子25 082例,双生子7934例,三生子33例;男21 179例,女11 870例;结果发现多生子ROP的发病率高于单生子(P<0.05);多生子组中低胎龄、低体重儿及颅内出血、贫血、窒息等疾病发生率高(P<0.05);多胎ROP发生更严重(P<0.05)。结论由于多生子出生体重轻、胎龄低及常合全身并发症,故ROP的发病率高于单生子,且发病早,病情相对严重。

Objective To investigate the clinic characteristics of retinopathy of prematurity（ROP） in twins or multiple infants.Methods Premature infants admitted to Ophthalmology Department Neonatal Department of Hunan Children′s Hospital from 2006 to 2011 were screened for ROP and recorded as ICROP stage,systemic complicins,clinical characteristics of ROP in multiple infants and singletons were analyzed.Results 33 049 premature infants（BW2000 g,GA35 w）,25 082 singletons,7934 twins and 33 triples,underwent ROP screen.394 patients（12.92%）were diagnosed as ROP,1.17% of Ⅳ-Ⅴ stage,16.24% of Ⅱ-Ⅲ stage,82.59% of Ⅰ-Ⅱ stage.The incidence of ROP in multiple infant was higher than that in singleton group.Lower birth weight and gestation age were more common in multiple infants.Conclusions ROP develop more frequently and earlier in multiple infants than in singletons because birth weight and gestation age are more lower and often with systemic complications in multiple fetus than in single infants.