早产儿视网膜病变的相关影响因素分析

Study on related influencing factors of retinopathy of premature infant

目的探讨早产儿视网膜病变的相关影响因素.方法本文选择我院2016年6月~2018年6月收治的2340例住院早产儿和低出生体重儿,描述研究对象的眼底检查结果,将所有研究对象根据眼底检查结果分为ROP组(n=384)和无ROP组(n=1956),比较两组儿童一般情况、临床治疗、并发症、孕母情况的差异及影响早产儿视网膜病变的多因素指标.结果 2340例早产儿中,男1334例,女1006例,诊断ROP为131例(5.6%),无ROP为2209例(94.4%).其中男70例,女61例;1期83例,2期35例,3期9例,4期3例,5期1例.性别、胎龄、出生体重、头围、Apgar评分、窒息与ROP是否发病有统计学差异(P<0.05);未发现单胎与ROP是否发病有差异(P>0.05).吸氧、输血、咖啡因、动脉导管未闭、颅内出血、胎儿宫内窘迫与ROP是否发病有统计学差异(P<0.05);未发现EPO、氨茶碱与ROP是否发病有差异(P>0.05).母亲年龄、产前激素、硫酸镁、妊高征、妊娠期糖尿病与ROP是否发病有统计学差异(P<0.05);未发现分娩胎次、受孕方式、贫血与ROP是否发病有差异(P>0.05).多元逐步Logistic回归分析显示,胎龄、吸氧、妊高征是早产儿患有ROP的危险因素(P<0.05).结论临床中对早产儿应给予视网膜病变的普遍筛查,加强高危孕产妇的管理,积极干预并发症,进而降低ROP疾病发生风险.

Objective To investigate the related influencing factors of retinopathy of premature infants. Methods 2340 premature infants and low birth weight infants who were admitted to our hospital from June 2016 to June 2018 were selected in this study, and the fundus examination results of the subjects were described. All subjects were divided into ROP group(n=384) and non-ROP group(n=1956) according to fundus examination results. The differences in general conditions, clinical treatment, complications, and maternal status between the two groups of infants and the multifactorial indices affecting retinopathy of premature infants were compared. Results Among 2340 premature infants, 1334 were male and 1006 were female. 131 cases (5.6%) were diagnosed with ROP, and 2209 cases(94.4%) were diagnosed with non-ROP. There were 70 males and 61 females;there were 83 cases in stage 1, 35 cases in stage 2, 9 cases in stage 3,3 cases in stage 4, and 1 case in stage 5. There were statistically significant differences in gender, gestational age, birth weight, head circumference, Apgar score, asphyxia and ROP(P<0.05);no difference was found between single birth and ROP(P>0.05);there were statistically significant differences in oxygen update, blood transfusion, caffeine, patent ductus arteriosus, intracranial hemorrhage, intrauterine distress and ROP(P<0.05);there was no difference in EPO,aminophylline and ROP(P>0.05). There were statistically significant differences in maternal age, prenatal hormone, magnesium sulfate, pregnancy-induced hypertension, gestational diabetes mellitus and ROP (P<0.05);there were no differences in birth parity, conception method of pregnancy, anemia and ROP(P>0.05). Multivariate stepwise Logistic regression analysis showed that gestational age, oxygen uptake, and pregnancy-induced hypertension were risk factors for ROP in premature infants(P<0.05). Conclusion In clinical settings, premature infants should be given universal screening for retinopathy, the management of high-risk maternal women should be strengthened, and complications should be actively intervened, thereby reducing the risk of ROP incidence.