超早产儿中早产儿视网膜病发病及治疗情况回顾性分析  

A retrospective analysis on the incidence and treatment outcomes of retinopathy of prematurity among extremely preterm infants

作　　者：连朝辉[1] 张国明[2] 林冰纯[1] 唐松[2] 刘培辉[1] 杨传忠[1] 

机构地区：[1]南方医科大学深圳妇幼保健院,深圳518028 [2]深圳市眼科医院,518026

出　　处：《中国小儿急救医学》2015年第7期491-493,共3页Chinese Pediatric Emergency Medicine

摘　　要：目的探讨超早产儿中早产儿视网膜病（retinopathy of prematurity，ROP）的发病率，并分析其中重症ROP的治疗方法与临床效果。方法对我院2006年4月至2013年10月出生并存活至少1年以上的胎龄〈28周的96例超早产儿进行回顾性分析，了解ROP的发病率，并分析激光光凝术及玻璃体腔内注入血管内皮生长因子抗体（雷珠单抗）治疗重症ROP患儿的方法、时机及疗效。结果96例超早产儿中共发生ROP56例，总发病率58．33％。其中重症ROP21例，占总ROP的37．5％，占总存活婴儿的21．88％，包括急进性后极ROP患儿2例（2．08％）。对重症ROP患儿中的15例给予单纯激光光凝术治疗；另6例先予玻璃体腔注入雷珠单抗，其中4例在1个月后加用激光光凝术治疗，2例无需再进行激光光凝术。全部患儿均保留视力，成功率100％。结论超早产儿中ROP发病率及重症发病率均非常高，应列为重点筛查对象；重症ROP患儿需及时进行激光光凝术，病情危重或急进性后极ROP患儿可结合使用血管内皮生长因子抗体治疗。Objective To analyze the incidence of retinopathy of prematurity （ROP） among extremely pretenn infants,and to evaluate the treatment methods and effects among those with severe ROP. Methods A retrospective analysis was performed to analyze incidence of ROP in 96 cases of extremely preterm infants who were born at a gestational age of 〈 28 weeks and survived beyond a postmenstrual age of at least 1 year from Apr 2006 to Oct 2013 ,and to analyze the treatment outcomes of photocoagulation and ranibizumab intravitreal injection among the infants with severe ROP. Results Fifty-six of 96 cases （58. 33 % ） grew into ROP finally and 21 cases（21.88% ）grew into severe ROP,2 cases（2.08% ）grew into aggressive posterior ROP. Fifteen cases with severe ROP were treated with laser photocoagulation. Four cases with severe ROP were received ranibizumab intravitreal injection prior to photocoagulation. Two cases with severe ROP were only treated with ranibizumab intravitreal injection. The eyesight of 96 patients （ 100% ） in this study were all preserved. Conclusion ROP screening should focus on extremely preterm infants because of higher incidence of ROP and severe ROP among them. The infants with severe ROP should be treated with laser photocoagulation in time. The infants in critical condition or with aggressive posterior ROP can be treated with ranibizumab injection.

关 键 词：超早产儿 早产儿视网膜病 激光光凝术 血管内皮生长因子抗体 

分 类 号：R779.6[医药卫生—眼科]