多波长氩离子激光治疗早产儿视网膜病变的疗效对比

Curative effect comparison of argon ion laser treatment for retinopathy of prematurity

目的比较多波长氩离子激光治疗急进性与阈值期或阈值前期早产儿视网膜病变（reti．nopathyofprematurity，ROP）的临床效果。方法临床病例回顾性对照研究。对2008年5月至2010年12月在白求恩第一医院眼科接受氩离子激光治疗的48例（94只眼）患有ROP患儿的临床资料。将其分为两组，一组：急进性早产儿视网膜病变（AP-ROP）组；二组：阈值期或阈值前期早产儿视网膜病变组。将两组ROP患儿采用多波长氩离子激光治疗的疗效及两组间各相关因素进行比较研究。结果48例（94只眼）患儿中18例（36只眼）为AP-ROP，治愈率88．89％；30例（58只眼）为阈值期或阈值前期ROP，治愈率94．83％，两组ROP患儿的治愈率比较差异无统计学意义（X^2=1．17，P=0．286，P〉0．05）。两组问各相关因素比较，新生儿呼吸窘迫综合征（X^2=11．27，P〈0．05）及早产儿贫血（X^2=7．27，P〈O．05）两组间差异具有统计学意义。患儿的性别、胎龄、激光治疗时矫正胎龄、出生体重、败血症、新生儿肺炎、先天性心脏病等因素两组间差异无统计学意义。结论氩离子激光治疗AP-ROP及阈值期或阈值前期ROP是安全且有效的，AP-ROP激光治疗治愈率较阈值期或阈值前期ROP低，新生儿呼吸窘迫综合征及新生儿贫血是影响ROP患儿激光光凝治愈率的危险因素。

Objective To make a comparative analysis of the clinical results with argon ion la- ser treatment between aggressive retinopathy of prematurity （ROP） and threshold （or prethreshold） ret- inopathy of prematurity. Methods A retrospective comparative analysis of 48 consecutive infants with ROP （94 eyes） and all the infants had required argon ion laser treatment in our hospital. These infants were divided into 2 groups： group A carried a diagnosis of aggressive retinopathy of prematu- rity （AP-ROP） and group B of threshold （or prethreshold） retinopathy of prematurity. The association between factors relevant and the efficacy outcomes of two ROP groups treated with multi wave- length argon ion laser were analyzed. Results Eighteen of 48 infants （36 of 94 eyes） were cases with aggressive retinopathy of prematurity, the cure rate was 88.89%. Thirty other infants （58 eyes） suffered from threshold （or prethreshold） retinopathy of prematurity, and the cure rate was 94.83%. There was no statistically significant different in the cure rates of two groups （Z2=1.17, P =0.286〉 0.05）. Compared with related factors between two groups, differences of Neonatal respiratory distress syndrome （X2=tl.27, P 〈0.05） and anemia of permaturity （X2=7.27, P 〈0.05） between two groups had statistical significance. The gender, the gestational age, the corrected gestational age, the birth weight, ichorrhemia, pneumonia of the newborn, congenital heart disease had no significant differ-ence. Conclusions The treatment with argon ion laser for aggressive retinopathy of prematurity and threshold （or prethreshold） retinopathy of prmrtaturity are safe and effective. Prognostic of threshold （or prethreshold） retinopathy of prematurity is better than aggressive retinopathy of prematurity. A closely relationship is found among neonatal respiratory distress syndrome, anemia of per maturity and the prognostic of retinopathy of prematurity.