1000g以下超低体重儿的早产儿视网膜病变筛查治疗分析

Extremely low body weight below 1000g newborn with retinopathy of prematurity:clinical characteristics and treatment outcomes

目的分析和评价1 000 g以下极低体重新生儿的早产儿视网膜病变(ROP)筛查及治疗情况。方法回顾性分析217例出生体重在1 000 g以下(含1 000 g)经双目间接眼底镜或RetCamII筛查的极低体重新生儿,并对其眼底检查结果、ROP患病情况及不同手术治疗方式进行分析比较。结果在217例新生儿中发现ROP患儿132例,发病率为60.8%,另外85例新生儿中发现其他眼部病变的10例(4.6%),完全正常75例(34.5%)。同时在ROP患儿中有96例行各种手术治疗,占ROP患儿的72.7%,手术方式中视网膜光凝治疗的有66例,玻璃体腔注药(AVASTIN)联合视网膜光凝治疗的有20例,单纯玻璃体注药治疗的有4例,另有6例行玻璃体手术治疗。结论极低体重新生儿的ROP患病率远高于1 000 g以上的新生儿,且患儿需手术治疗的ROP重症率极高,常需要联合多种治疗手段进行干预。

Objective To analyze and evaluate the screening and treatment outcomes of extremely low body weight below 1 000 g newborn with retinopathy of prematurity（ROP）.Methods Totally 217 premature infants who were body weight ≤1 000 g at birth,were enrolled in this study.Their fundus were routinely checked by binocular indirect ophthalmoscope and RetCam II.Diagnosis and staging of ROP were performed according to the international guidelines.The screening and treatment outcomes of ROP were statistically analyzed.Results The incidence of ROP was 60.8%（132 patients）,and other ocular pathological changes in 10 cases（4.6%）.96 patients（72.7%） suffered from ROP were treated by the several surgical methods,including retinal photocoagulation in 66 cases,vitreous injection of combined photocoagulation in 20 cases,vitreous injection in 4 case and vitrectomy in 6 cases.Conclusion The incidence of ROP to extremely low body weight infants is much higher than that of the 1 000 g above newborns.The patient has a high probability of surgical treatment,and often need to join a variety of treatment interventions.