多胎儿早产儿视网膜病变筛查结果分析

Analysis of the clinical characteristics of retinopathy in multiple premature infants

目的了解多胎儿早产儿视网膜病变(ROP)发病情况并分析其临床特征。方法回顾性临床研究。2009年12月至2018年6月于东莞市人民医院眼科门诊及新生儿科住院并接受ROP筛查的早产或低体重多胎儿758名(多胎组)和同期单胎儿2363名(单胎组)纳入研究。多胎组中,双胎735名,三胎23名。多胎组758名中,男性441名,女性317名。平均出生胎龄(32.22±2.14)周,平均体重(1.69±0.43)kg。顺产202名,剖宫产556名;有吸氧史750名。单胎组2363名中,男性1421名,女性942名。平均出生胎龄(32.06±2.52)周,平均体重(1.70±0.46)kg。顺产1146名,剖宫产1217名。有吸氧史2333名。观察多胎ROP检出率以及ROP患儿出生胎龄、出生体重、性别构成比、生产方式、首次ROP诊断时间以及ROP严重程度。组间率的比较行χ^2检验,均数比较行t检验。结果多胎组758名中,检出ROP 68例(8.97%)。其中,双胎64例(8.71%,64/735);三胎4例(17.39%,4/23)。单胎组2363名中,检出ROP 187例(7.91%)。随胎数增加,ROP检出率逐渐升高,但不同胎数ROP检出率比较,差异无统计学意义(χ^2=3.097,P=0.213)。多胎组、单胎组受检儿ROP检出率比较,差异无统计学意义(χ^2=0.855,P=0.355)。单胎组、多胎组ROP患儿性别构成(χ^2=0.069)、生产方式(χ^2=1.900)、出生体重(t=0.139)、出生胎龄(t=-0.478)、首次ROP诊断时间(t=0.371)比较,差异均无统计学意义(P=0.793、0.168、0.889、0.633、0.371);不同病变程度发生率比较,差异无统计学意义(χ^2=3.003,P=0.223)。结论与同等条件单胎儿比较,多胎儿ROP发生率、出生胎龄、出生体重、ROP诊断时间以及ROP严重程度差异均无统计学意义。

Objective To observe the clinical features of retinopathy of prematurity(ROP)in multiple fetuses.Methods Retrospective clinical study.From December 2009 to June 201&758 premature or low-weight multiple fetuses(multiple fetuses group)and 2363 simultaneous single fetuses(single fetuses group)who were admitted to the Department of Ophthalmology and TVeonatal Department of Dongguan People's Hospital and underwent ROP screening were included in the study.Among the multiple pregnancy group,there were 735 twins and 23 triplets;441 males and 317 females.The mean gestational age was 32.22±2.14 weeks,and the mean body weight was 1.69±0.43 kg.There were 202 of natural births and 556 of cesarean sections.A total of 750 cases have a history of oxygen.Among the singleton group,1421 were males and 942 were females.The mean gestational age was 32.06±2.52 weeks,and the mean body weight was 1.70±0.46 kg.There were 1146 of natural births and 1217 of cesarean sections.A total of 2333 cases have a history of oxygen.The detection rate of multiple ROP,gestational age,birth weight,sex composition ratio,mode of birth,time of first ROP diagnosis,and severity of ROP were observed.χ^2 test was used to compare the rate between groups,and t test was used to compare the mean between groups.Results Among the multiple pregnancy group,there were 68 cases(8.97%)of ROP.Among them,64 twins(8.71%,64/735),4 triplets(17.39%,4/23).Among the singleton group,there were 187 cases(7.91%)of ROP.With the increase of fetal number,the detection rate of ROP increased,but there was no significant difference(χ^2=3.097,P=0.213).There was no significant difference in the detection rate of ROP between multiple fetuses and single fetuses(χ^2=0.855,P=0.355).There was no significant difference in sex ratio(χ^2=0.069),mode of production(χ^2=1.900),birth weight(t=0.139),gestational age(t=-0.478),and time of first ROP diagnosis(t=0.371)between ROP cases of multiple fetuses and single fetuses(P=0.793,0.16&0.889,0.633,0.371).There was no significant difference in the constituent ratio of severity of ROP lesions between multiple fetuses and single fetuses(χ^2=3.003,P=0.223).Conclusion There is no significant difference in ROP incidence,gestational age,birth weight,diagnosis time and severity of ROP between multiple fetuses and single fetuses under the same conditions.