新生儿眼底病变筛查及视网膜出血的影响因素

Clinic analysis of fundus screening and the risk factors of retinal hemorrhage in neonates

目的:筛查统计新生儿眼底病变的基本情况,并探讨新生儿视网膜出血的影响因素。方法:收集2016-01-01/2018-05-31于我院产科病房及新生儿重症监护病房采用儿童数字化广域成像系统(RetcamⅢ)进行眼底筛查的新生儿,记录其性别、胎龄、分娩方式、窒息史、母孕史等临床资料,并对筛查结果进行统计分析。结果:本研究纳入新生儿289例,其中早产儿97例,足月儿192例。检出眼底病变者64例(22. 1%),其中视网膜出血者34例(11. 8%)、早产儿视网膜病变者23例(8. 0%)。单因素分析发现,胎龄、分娩方式、经阴产情况、有无窒息史、有无母孕期妊高征史、分娩史是新生儿视网膜出血的影响因素。多因素Logistic回归分析显示,早产儿、经阴道分娩、有窒息史、母孕期妊高征史是新生儿视网膜出血的高危因素。结论:新生儿视网膜出血发生率较高,其与胎龄、分娩方式、窒息史、母孕期妊高征史等多种因素相关,临床诊疗中应高度重视新生儿眼底病变的筛查。

AIM:To understand the basic conditions of neonatal fundus lesions and analyze the influencing factors of retinal hemorrhage.METHODS:Totally 289 neonates from our hospital in the department of obstetric ward and neonatal intensive care unit from January 1,2016 to May 31,2018 were screened for fundus oculi disease by Retcam Ⅲ.The following information were collected such as gender,gestational age,history of asphyxia,maternal pregnancy and delivery way.RESULTS:Among the 289 infants,there were 97 premature infants and 192 term infants.Sixty-four(22.1%)were detected with fundus lesions.Among which,34(11.8%)were detected with retinal hemorrhage and 23(8.0%)retinopathy of prematurity.Single factor analysis showed that the rate of retinal hemorrhage in premature infants was higher than term(P<0.05).The rate of retinal hemorrhage in neonates with perineal delivery was higher than cesarean section(P<0.05).The rate of retinal hemorrhage in neonates with a history of asphyxiation was higher than that without(P<0.05).The rate of retinal hemorrhage in neonates with high blood pressure during pregnancy was higher than that without(P<0.05).After adjusting for the effects of risk factors,preterm infants,perineal births,history of asphyxiation,and high blood pressure during pregnancy were the high risk factors for neonatal retinal hemorrhage(P<0.05).CONCLUSION:The incidence of neonatal retinal hemorrhage is relatively high,which is related to factors such as gestational age,mode of delivery,history of asphyxia and history of maternal pregnancy hypertension.