早产儿视网膜病筛查及相关因素的临床分析  

Clinical Evaluation on the Screening of Retinopathy of Prematurity an d Its Relevant Risk Factors

作　　者：张应金[1] 黄建伟[1] 黄润忠[1] 梁凤潇[1] 苏永棉[1] 张金凤[1] 廖南萍[1] 

机构地区：[1]暨南大学附属顺德妇幼保健院新生儿科,广东顺德528300

出　　处：《中华妇幼临床医学杂志（电子版）》2012年第2期164-167,共4页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

摘　　要：目的了解早产儿视网膜病变(ROP)的发生状况,并探讨ROP的相关危险因素。方法选择2009年1月至2010年12月在本院新生儿科住院的250例早产儿为研究对象,胎龄≤36孕周,出生体重≤2500g。于生后第14天对其进行ROP筛查,记录早产儿一般临床资料。早产儿完成ROP筛查后,对其随访至周边视网膜新生血管形成或病变退化(本研究遵循的程序符合本院人体试验委员会制定的伦理学标准,得到该委员会批准,并与受试对象监护人签订临床研究知情同意书)。采用非条件logistic多元回归分析法进行ROP相关危险因素[胎龄、胎次、出生体重、性别、吸氧持续时间及浓度、机械通气治疗、是否合并新生儿窒息、呼吸暂停、呼吸窘迫综合征(RDS)并发症及是否输血等]分析。结果 250例早产儿全部完成ROP筛查,共计检出ROP16例(26只眼),ROP发生率分别为6.4%(16/250,ROP患儿发病率)和5.2%(26/500,ROP眼发病率),其中ROP1期为12例(75.0%),2期为3例(18.8%),3期为1例(6.3%)。非条件logisticROP相关危险因素分析结果显示,ROP与早产儿胎龄、吸氧持续时间及浓度、接受机械通气治疗密切相关(OR=0.668,95%CI:-0.721～-0.088,P=0.012;OR=7.768,95%CI:0.608～3.492,P=0.005;OR=5.241,95%CI:0.191～3.121,P=0.027;OR=1.235,95%CI:1.109～2.872,P=0.001);其余因素与ROP无相关关系(P>0.05)。结论早产、吸氧持续时间长及浓度高、接受机械通气治疗是发生ROP的主要危险因素。对早产儿适时进行ROP筛查,可为临床防治ROP提供理论依据。Objective To investigate the screening of retinop athy of prematurity（ROP） and its related risk factors.Methods Fr om January 2009 to December 2010,a total of 250 preterm newborns were recruited into this study.The gestational ages were less than 36 gestational weeks,birt h weights were under 2500 g.All the cases underwent ROP screening at one week a fter birth,and then received regular follow-up until peripheral retinal neovascularization or lesion degradation.The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Maternal and Child Heal th Hospital of Shunde,Jinan University.Informed consent was obtained from the parents of each participating neonate.The relationship among ROP and systemic c onditions and oxygen inhalation of newborns,oxygen inhalation volume of mother during pregnancy,preeclampsia,placental abruption and other factors were analy zed,respectively.Results All the 250 newborns completed the r etinal screening.A total of 16 newborns（26 eyes） were found ROP,and the preva lence rate of ROP were 6.4%（16/250） and 5.2%（26/500）,respectively,in which 12 cases（75.0%） of grade 1,3（18.8%） of grade 2 and 1（6.3%）of grade 3.Univaria te analysis o f risk factors of ROP showed gestational age,birth weight,oxygen inhalation t ime,oxygen inhalation concentration,mechanical ventilation were associated with ROP（P0.05）.Oxy gen inhalation during pregnancy,preeclampsia,placental abruption had no correl ation with ROP（P0.05）.Conclusions Premature birth,hig h concentrations of ox ygen inhalation,mechanical ventilation are major risk factors of ROP.Preterm n ewborns should have regular screening and follow-up in order to find the lesion as soon as possible to decrease the incidence rate of blindness.

关 键 词：早产儿 早产儿视网膜病 筛查 危险因素 新生儿 

分 类 号：R722.6[医药卫生—儿科] R774.1[医药卫生—临床医学]