早产儿视网膜病变的转归情况及其进展至重度的危险因素分析

Analysis of Outcome of Retinopathy in Premature Infants and Risk Factors for Its Progression to Severe

目的:分析早产儿视网膜病变的转归情况及其进展至重度的危险因素。方法:选取2016年1月-2019年6月本院95例视网膜病变早产儿为研究对象。随访6个月,观察所有患儿的转归情况,比较不同新生儿因素(性别、胎龄、体重、1 min Apgar评分、感染情况及先天性疾病情况)及其他因素(机械通气时间、母亲妊娠期疾病情况、肺表面活性物质应用情况及分娩方式)者的转归情况,并分析早产儿视网膜病变进展至重度的危险因素。结果:95例早产儿中进展至重度者30例(31.58%),自然消退者65例(68.42%)。不同性别、先天性疾病、母亲妊娠期疾病、肺表面活性物质应用情况及分娩方式的早产儿转归情况比较,差异均无统计学意义(P>0.05),而不同胎龄、体重、1 min Apgar评分、感染情况及机械通气时间的早产儿转归情况比较,差异均有统计学意义(P<0.05);多因素logistic回归分析显示,胎龄、体重、1 min Apgar评分、感染情况及机械通气时间均为早产儿视网膜病变进展至重度的危险因素(P<0.05)。结论:早产儿视网膜病变进展至重度的概率较高。胎龄、体重、1 min Apgar评分、感染情况及机械通气时间均为早产儿视网膜病变进展至重度的危险因素,可作为防控与干预措施制定的参考依据。

Objective:To analyze the outcome of retinopathy in premature infants and the risk factors for its progression to severe.Method:From January 2016 to June 2019,95 premature infants with retinopathy in our hospital were selected as the study subjects.Followed up for 6 months,the outcome of all children were observed,the outcomes of premature infants with different neonatal factors (gender,gestational age,weight,1 min Apgar score,infection and congenital diseases) and other factors (mechanical ventilation time,maternal diseases during pregnancy,application of pulmonary surfactant and mode of delivery) were compared,and the risk factors for the progression of retinopathy to severe in premature infants were analyzed.Result:Among 95 premature infants,30 cases (31.58%) had progression to severe,and 65 cases (68.42%) had natural regression.There were no significant differences in the outcome of premature infants with different genders,congenital diseases,maternal pregnancy diseases,pulmonary surfactant application and delivery mode (P>0.05),while there were significant differences in the outcomes of premature infants with different gestational age,body weight,1 min Apgar score,infection and mechanical ventilation time (P<0.05);multivariate logistic regression analysis showed that gestational age,body weight,1 min Apgar score,infection and mechanical ventilation time were the risk factors for the progression of retinopathy to severe in premature infants (P<0.05).Conclusion:The progression to severe rates of premature infants retinopathy is high.Gestational age,body weight,1 min Apgar score,infection status and mechanical ventilation time are all risk factors for the progression to severe retinopathy of premature infants,which can be used as a reference for prevention and control and intervention.