母乳喂养对早产儿视网膜病变发病的影响研究

Study on the effect of milk feeding on the incidence of retinopathy of prematurity

目的观察母乳喂养对早产儿视网膜病变(ROP)发病的影响。方法回顾性临床研究。2017年6月至2019年12月于宁波市妇女儿童医院出生并接受ROP筛查的早产儿628例1256只眼纳入研究。其中,男性325例650只眼,女性303例606只眼。根据喂养情况,将早产儿分为母乳喂养(研究)组和配方奶喂养(对照)组,分别为390例780只眼和238例476只眼。对比观察两组早产儿在观察期间的眼底视网膜变化情况。组间定性资料比较行χ^(2)检验;定量资料比较行两独立样本t检验。结果研究组、对照组早产儿性别构成比(χ^(2)=0.217)、出生体重(t=0.728)、出生胎龄(t=0.351)、出生时Apgar评分(t=0.816)、吸氧时间(t=0.427)、新生儿重症监护病房住院时间(t=1.580)比较,差异均无统计学意义(P>0.05)。研究组390例中,有无ROP分别为108(27.7%,108/390)、282(72.3%,282/390)例;对照组238例中,有无ROP分别为86(36.1%,86/238)、152(63.9%,152/238)例。两组ROP发病率比较,差异有统计学意义(χ^(2)=4.934,P=0.026)。研究组ROP 108例中,1、2、3期分别为50(12.8%,50/108)、35(9.0%,35/108)、23(5.9%,23/108)例。对照组ROP 86例中,1、2、3期分别为25(10.5%,25/86)、40(16.8%,40/86)、21(8.8%,21/86)。两组ROP分期比较,1期差异无统计学意义(χ^(2)=0.754,P>0.05);2期及以上差异有统计学意义(χ^(2)=11.400,P<0.05)。结论母乳喂养或能降低ROP发病率及严重程度。

Objective To observe the effect of breastfeeding on the incidence of retinopathy of prematurity(ROP).Methods A retrospective clinical study.From June 2017 to December 2019,1256 eyes of 628 premature infants who were born in Ningbo Women and Children's Hospital and were screened for ROP were included in the study.Among them,there were in 325 males(650 eyes)and 303 females(606 eyes).According to the feeding situation,premature infants were divided into breastfeeding(research)group and formula feeding(control)group,with 390 cases of 780 eyes and 238 cases of 476 eyes,respectively.The changes in the retina of the fundus of the two groups of premature infants during the observation period were compared.The qualitative data comparison between groups was performed by theχ^(2) test;the quantitative data comparison was performed by the two independent sample t test.Results The sex ratio of premature infants in the study group and control group(χ^(2)=0.217),birth weight(t=0.728),gestational age at birth(t=0.351),Apgar score at birth(t=0.816),oxygen inhalation time(t=0.427),were compared with the length of stay in the neonatal intensive care unit(t=1.580),the difference was not statistically significant(P>0.05).Among the 390 cases in the study group,108 cases(27.7%,108/390)and 282 cases(72.3%,282/390)were with or without ROP,respectively;in the 238 cases in the control group,86(36.1%,86/238)were with ROP,152(63.9%,152/238)cases were without ROP.There was a statistically significant difference in the incidence of ROP between the two groups(χ^(2)=4.934,P=0.026).Among the 108 cases of ROP in the study group,50(12.8%,50/108),35(9.0%,35/108),23(5.9%,23/108)cases were in stage 1,2 and 3,respectively.Among the 86 ROP cases in the control group,stages 1,2 and 3 were 25(10.5%,25/86),40(16.8%,40/86),and 21(8.8%,21/86),respectively.In the comparison of ROP staging between the two groups,the difference in stage 1 was not statistically significant(χ^(2)=0.754,P>0.05),and the difference in stage 2 and above was statistically significant(χ^(2)=11.400,P<0.05).Conclusion Breastfeeding may reduce the incidence and severity of ROP.