母乳喂养对双胎早产儿视网膜病变发生率及严重程度的影响

The research on the effect of breastfeeding on retinopathy of prematurity among premature twins

目的：通过观察摄入母乳或早产儿配方乳的双胎早产患儿眼底检查结果，评价母乳喂养对双胎早产儿视网膜病变（retinopathy of prematurity ，ROP）的发病率及严重程度的影响。方法对2012年6月至2013年6月在本院就诊的30对双胎早产儿（120只眼）在综合治疗的基础上，以相同标准的开奶时机开始肠内喂养。随机选取双胎中一名进行母乳喂养，另一名进行配方乳喂养，所有患儿在出生后4~6周或矫正胎龄32~34周开始进行ROP 眼底检查及随访，直至视网膜发育达到要求。收集数据进行统计分析。结果（1）两组患儿的眼底检查结果比较，差异无统计学意义。且两组间 ROP 病变程度及手术率相比，差异亦无统计学意义。（2）多因素 logistic 回归分析显示，用氧天数及母乳喂养与 ROP 有关，用氧天数是危险因子，母乳喂养是保护因子。结论用氧是双胞胎早产儿视网膜病变的危险因素，母乳喂养则是其保护因素，母乳喂养与早产儿双胎中的 ROP 发病率、病变严重程度及手术率有相关性。

ObJective：To provide the evidence of developing treatment strategies which can reduce the retinopathy inci-dence and severity by observing the fundus examination results of twin premature infants who have intake the different con-tent of breast milk or formula milk. Methods：We identified VLBW infants admitted to our hospital clinic from June 2012 though June 2013. All the infants,30 twin premature infants（120 eyes）,had received propaganda breast feeding and been divided into the breastfeeding group and the formula feeding group . The two groups of children was enter to be fed by the same standard on the basis of comprehensive treatment. The first ROP fundus examination began on 4 ~ 6 weeks after newborn or correction embryo age for 32 ~ 34 weeks,and following inspection was made according to the stipulation deci-sion. Children had continued follow-up examination after discharge until retinal development to meet the requirements. We established the babyˊs ROP research file and carried on the data analysis. Results：（1）There was no significant difference between the two groups of children with fundus examination results with statistically two samples were comparable. There was no significant difference in ROP lesion degree and the operation rate between the two groups,P 〉 0. 05,and.（2）The Multivariate logistic regression analysis showed that the days with oxygen and breastfeeding were associated with ROP,the number of days with oxygen was a risk factor,and breastfeeding was a protective factor. Conclusion：Oxygen is a risk factor and breastfeeding is a protection factor for premature twins retinopathy. In addition,there is a correlation between breast-feeding and the incidence,disease severity and operation rate of ROP among premature twins .