早产儿视网膜病变的筛查分析

Screening Analysis of Retinopathy of Prematurity in Premature Infants

目的 探讨早产儿视网膜病变（ROP）的临床特点.方法 选择2010年7月8日至2012年9月6日在成都市妇女儿童中心医院新生儿科实业街分部收治的93例接受ROP筛查的早产儿、低出生体重（LBW）儿为研究对象.其中,男性为48例,女性为45例,平均出生体重为（1547±345）g,胎龄为（27～36）孕周,平均为（31±2）孕周（本研究遵循的程序符合本院人体试验委员会制定的伦理学标准,得到该委员会批准,并征得患儿家属的知情同意）.回顾性分析其ROP的临床特点.结果 93例接受ROP筛查的儿童中,10例出现ROP,发病率为10.75%.体重＜1200 g者ROP发病率为3.23%（3/93）,（1200～1700）g为5.38%（5/93）,（1701～2200）g为2.15%（2/93）.分娩孕龄≤30孕周的ROP发病率为4.30%（4/93）,分娩孕周为（31~32）孕周的ROP发病率为6.45%（6/93）.ROP相关因素的疾病表现为呼吸暂停（χ2=5.03,P〈0.05）、新生儿呼吸窘迫综合征（NRDS）（χ2=6.84,P〈0.05）、新生儿肺炎（χ2=7.55,P〈0.05）、病理性黄疸（χ2=3.98,P〈0.05）、窒息（χ2=8.46,P〈0.05）和呼吸机相关性肺炎（VAP）（χ2=3.56,P〈0.05）.结论早产儿应及时行规范的眼底检查,对ROP应早发现、早治疗.

Objective To investigate the clinical features of retinopathy of prematurity （ROP）. Methods From July 2010 to September 2012, a total of 93 cases （48 boys and 45 girls） of premature and low birth weight （LBW） infants were included into this study. They were received ROP screening in Neonatology Department of Chengdu Women＇s and Children＇s Center Hospital. Their average birth weight was （1547±345） g, gestational age varied from 27 to 36 gestational weeks, and the average gestational age was （31 ±2） weeks. The procedure followed in this study met the hospital ethical standards established by the Institutional Review Board, obtained its approval and the informed consent from the families of children. The retrospective analysis of the clinical features of ROP were conducted. Results In these 93 cases, ten were found of ROP and the incidence rate was 10.75%. The incidence rate of ROP of weight less than 1200 gwas 3.23% （3/93）, （1200-1700）g was 5.38% （5/93）, （170l 2200） g was 2.15% （2/93）. The related factors of ROP were apnea （x2= 5.03,P〈0.05）, neonatal respiratory distress syndrome （NRDS） （x2=6.84,P〈0.05）, pneumonia of newborn （ x2 =7.55,P〈0.05）, jaundice （ x2 =3.98,P〈0.05）, asphyxia （ x2 = 8.46,P〈0.05）, and ventilator associated pneumonia （VAP） （x2= 3.56, P〈0.05）. Conclusions Premature infants should take normal fundus examination to detect ROP as early as possible.