早产儿视网膜病变的危险因素分析

Analysis of risk factors of retinopathy in preterm infants

目的分析早产儿视网膜病变的危险因素。方法将2019年10月至2020年3月在我院新生儿重症监护病房(NICU)接受住院监护和眼科筛查的300例早产儿纳入研究,统计早产儿视网膜病变发生情况。根据早产儿是否发生视网膜病变将其分为观察组(发生视网膜病变)与对照组(未发生视网膜病变)。比较两组早产儿的临床资料,并对导致早产儿发生视网膜病变的危险因素进行分析。结果 300例早产儿中有29例发生视网膜病变,视网膜病变发生率为9.67%。单因素分析结果显示,观察组胎龄<30周、出生体质量<1 500 g、吸氧时间≥7 d、新生儿呼吸暂停、新生儿肺炎、新生儿高胆红素血症、胎儿宫内窘迫、母体宫内感染、母体妊娠期高血压、母体妊娠期糖尿病的早产儿占比高于对照组(P<0.05)。多因素Logistic回归分析结果显示,胎龄、出生体质量、吸氧时间、新生儿呼吸暂停、新生儿肺炎、新生儿高胆红素血症、胎儿宫内窘迫、母体宫内感染、母体妊娠期高血压、母体妊娠期糖尿病是早产儿视网膜病变的危险因素(P<0.05)。结论早产儿视网膜病变的发生率较高,其发生主要与胎龄、出生体质量、吸氧时间、新生儿合并症、妊娠期母体异常情况有关,临床上应根据早产儿视网膜病变的危险因素在妊娠期采取针对性的干预措施,以降低早产儿视网膜病变风险。

Objective To analyze the risk factors of retinopathy of preterm infants.Methods From October 2019 to March 2020,300 preterm infants who received in-hospital care and ophthalmic screening in neonatal intensive care unit(NICU)of our hospital were included in the study.The occurrence of retinopathy of preterm infants was counted.According to whether retinopathy of preterm infants occurred or not,the preterm infants were divided into observation group(with retinopathy)and control group(without retinopathy).The clinical datas of the two groups were compared,and the risk factors of retinopathy of preterm infants were analyzed.Results Among the 300 preterm infants,29 cases had retinopathy,the incidence of retinopathy was 9.67%.Univariate analysis showed that the proportions of preterm infants with gestational age<30 weeks,birth weight<1500 g,oxygen inhalation time≥7 d,neonatal apnea,neonatal pneumonia,neonatal hyperbilirubinemia,fetal distress,maternal intrauterine infection,maternal gestational hypertension,maternal gestational diabetes mellitus in the observation group were higher than those in the control group(P<0.05).The multivariate Logistic regression analysis showed that gestational age,birth weight,oxygen inhalation time,neonatal apnea,neonatal pneumonia,neonatal hyperbilirubinemia,fetal distress,maternal intrauterine infection,maternal gestational hypertension,maternal gestational diabetes mellitus were risk factors of retinopathy in preterm infants(P<0.05).Conclusion The incidence of retinopathy of preterm infants is higher,which is mainly related to gestational age,birth weight,oxygen inhalation time,neonatal complications and maternal abnormalities during pregnancy.In clinical practice,targeted intervention measures during pregnancy should be taken according to the risk factors of retinopathy of preterm infants to reduce the risk of retinopathy of preterm infants.