2012年佛山市早产儿视网膜病变防治现状调查

Current situation of retinopathy of prematurity management in premature infants in Foshan City

目的了解佛山市三级医院早产儿视网膜病变(ROP)的防治现状及其影响因素,为进一步规范早产儿用氧及提高ROP防治水平提供参考依据。方法采用多中心回顾性研究方法,设计临床调查表,对2012年佛山市共24家各级医院ROP防治情况进行调查并汇总分析。结果全市24家医院2012年共收治早产儿4 763例,出生体重<2 000 g者2 232例,<1 500 g者753例,<1 000 g者57例;有12家医院已开展ROP筛查,普及率50%,其中10家为本院筛查,2家送本市其他医院筛查;全市共筛查早产儿1 596例,检出ROP 59例,检出率为3.7%,其中达阈值ROP者11例,检出率为0.69%。全市尚未开展ROP治疗。结论佛山市三级甲等医院NICU在早产儿用氧及ROP筛查方面已取得相当成绩,一级医院及大部分二级医院筛查率和阳性率低,氧疗设施不齐、氧浓度监测不力、ROP防治意识不强、缺乏专业培训及眼科专业人才等,需要建立一个规范的筛查管理模式来加强佛山市ROP防治工作。

Objective To investigate the current situation of retinopathy of prematurity （ROP） management in tertiary hospitals of Foshan City and associated factors for evidence of standard oxygen therapy in preterm infants and further improvement of ROP management. Methods This was a retrospective multiccnter investigation. Data of ROP management in 24 hospitals of Foshan City in 2012 were collected via a clinically oriented questionnaire and analyzed. Results 4 783 cases of premature infants were treated in 24 hospitals in 2012, among them 2 232 cases with birth weight （BW） 〈2 000 g, 753 cases with BW 〈 1 500 g, and 57 cases with BW 〈 1 000 g. 12（50% ） hospitals had ROP screening, 10 of whom conducted screening on their own and 2 of whom performed send - out screening. A total of 1 596 cases had been screened and 59 were positive for ROP,with a detection rate of 3.7%. Among 59 positive cases, 11 threshold ROP cases were detected with a detection rate of 0. 69%. ROP treatment was not available in any hospital of Foshan City. Conclusion Tertiary hospitals of Foshan have considerable achievement in the aspect of oxygen therapy and ROP management. However, the screening rate and detection rate are low in most hospitals of lower levels. Problems exist including insufficient oxygen therapy equipment, inadequate oxygen concentration monitoring, low ROP prevention awareness, lack of professional training and ophthalmology specialty staff. A standard paradigm of ROP management is strongly suggested to improve the overall quality of ROP management in Foshan City.