早产儿视网膜病的高危因素分析

Risk factor analysis of retinopathy of prematurity

目的了解我院早产儿视网膜病（refinopathy of prematurity，ROP）的发病状况，并对其高危因素进行分析。方法对2010年1月至2012年12月在我院新生儿科住院的早产儿（胎龄≤36周，体重≤2．5kg），于生后2周进行ROP筛查，并定期随访。将患儿全身状况及吸氧、母孕期吸氧、先兆子痫、胎盘早剥等因素进行分析。结果255例患儿全部完成了眼底筛查，在周边视网膜血管化或病变退化后终止随访，发现ROP16例（26只眼），ROP患病率为6．3％（5．1％），其中Ⅰ期12例，Ⅱ期3例，Ⅲ期1例。高危因素分析示胎龄、出生体重、吸氧时间，吸氧浓度、机械通气与ROP相关（P〈0．05）；母孕期吸氧、先兆子痫、胎盘早剥等因素与ROP发病无关。结论早产、吸氧浓度高、机械通气是ROP的主要危险因素。对早产儿适时进行ROP筛查，并对发现的ROP早期进行有效视网膜激光光凝术，可控制病变，降低早产儿的致盲率。

Objective To investigate the incidence of retinopathy of prematurity （ROP） in our hospital and to explore the risk factors of ROP. Methods Premature infants hospitalized in our hospital in January 2010 to December 2012 were chosen, and the gestational ages were less than 36 gestational weeks, birth weights were under 2 500 g. All the cases underwent ROP screening at two weeks after birth, and then they received regular follow-up. Children with systemic conditions and oxygen to the mother during pregnancy, oxygen,preeclampsia, placental abruption, and other factors were analyzed. Results Two hundred and fifty-five cases completed the retinal screening, terminated follow-up after the peripheral retinal neovascularization or disease degradation. We found ROP in 16 cases （26 eyes） ,ROP prevalence rate was 6. 3% （5.1%） ,including phase Ⅰ 12 cases, phase Ⅱ 3 cases, phase Ⅲ 1 case. Gestational age, birth weight, inhale oxygen time, oxygen concentration, mechanical ventilation were associated with ROP （P 〈 0.05 ）. Mother oxygen during pregnancy, preeclampsia,placental abruption had nothing to do with the incidence of ROP. Conclusion Premature birth, high concentrations of oxygen, mechanical ventilation are major risk factors of ROP. Timely screening of ROP and found early to do the retinal laser photocoagulation in premature, can control the disease, reduce the blindness rate of premature infants.