Retcam-3检查足月新生儿视网膜出血分级的初步探讨

An investigation of the standard of classification of retinal hemorrhage in full-term normal delivery newborns according to digital wide-angle retinal imaging device RetCam-3

目的采用广域数码视网膜成像系统(Retcam-3)探讨足月新生儿视网膜出血的分级方法。方法对1 021例顺产足月新生儿(2 042眼)出生3 d内进行Retcam-3眼底照相,初次检查发现视网膜出血者分别于3、4、6周后复查眼底。根据视网膜出血位置和黄斑出血程度对视网膜出血进行分级,提出Retcam-3检查视网膜出血的分级标准,分析视网膜出血与第二产程的关系。结果 1 021例新生儿中,165例(17.14%)发生视网膜出血。其中,Ⅰ级出血155例,占16.16%;Ⅱ级出血9例,占0.88%;Ⅲ级出血1例,占0.01%。无视网膜出血新生儿的第二产程时间为(49.81±5.3)min,视网膜出血患儿的第二产程时间为(51.13±6.12)min,视网膜出血患儿第二产程时间较无出血患儿延长,差异具有统计学意义(t=2.839,P=0.005)。结论根据Retcam-3检查将足月新生儿视网膜出血分为三级:Ⅰ级为浅层视网膜出血不包括黄斑部,3周内吸收;Ⅱ级为浅层视网膜出血包括黄斑部,6周内吸收;Ⅲ级为浓厚视网膜前出血遮盖黄斑部,吸收时间超过6周。第二产程延长是导致视网膜出血的可能危险因素。

Objective To probe the classification of retinal hemorrhage（RH）in vaginal delivery term newborns accord-ing to digital wide-angle retinal imaging device（RetCam-3 ）.Methods A total of 1 021 healthy full-term normal delivery newborns（2 042 eyes）were enrolled in this study.A digital wide-angle retinal imaging device（RetCam m）was used to examine the subjects at about 3 days after birth.Newborns with RH were reexamined after three,four and six weeks.RH was classified according to the location of RH and degree of hemorrhage in macular by RetCam-3.Results In 1 021 cases of newborns,retinal hemorrhages were found in 165 infants（17.14%）.Within these 165 infants,155 infants（16.16%）wereⅠdegree retinal hemorrhage,9 infants（0.88%）were Ⅱdegree retinal hemorrhage and 1 infant （0.01%）was Ⅲ degree retinal hemorrhage.The average time of second stage of labor in newborns without RH was 49.81 ±5.3 minites.The average time of second stage of labor in newborns with RH was 51.13 ±6.12 minutes.New-borns with RH had longer second stage of labor than those without RH.The difference was statistically significant （t =2.839,P =0.005）.Conclusion According to the result of RetCam-3 of 2 042 eyes,we classify RH in degreeⅠ,Ⅱand Ⅲ.RH of DegreeⅠis located in the superficial retina and resolves itself within three weeks after birth.RH of DegreeⅡ is located in the superficial retina including macular and resolves itself within six weeks after birth.RH of De-gree Ⅲ is located ahead of retina including macular and does not resolve itself within six weeks after birth.Prolonged second stage of labor may play roles of risk factor in retinal hemorrhage.