足月新生儿视网膜出血危险因素的临床分析  

Clinical analysis of risk factors of retinal hemorrhage in full-term newborns

作　　者：耿韶辉[1] 王雅从[1] 张静[1] 李艳涛[1] 张佳佳[1] 张炜[1] 

机构地区：[1]河北省石家庄市第四医院眼科,石家庄050011

出　　处：《中国眼耳鼻喉科杂志》2016年第4期255-257,共3页Chinese Journal of Ophthalmology and Otorhinolaryngology

基　　金：卫生部卫生行业科研专项项目(201002019);石家庄市科技支撑计划项目(111461013)

摘　　要：目的 探究足月新生儿视网膜出血的临床危险因素。方法 收集2014年12月~2015年7月在本院出生后15 d内接受Ret CamⅢ眼底检查的1 017例足月新生儿资料。观察性别、胎次、出生体重、妊娠期高血压、妊娠期糖尿病、分娩方式、脐带绕颈、脐带扭转及新生儿全身情况。将受检新生儿分为视网膜出血组和对照组,分析新生儿视网膜出血的可能影响因素。结果 1 017例新生儿视网膜出血的发病率为19.6%。视网膜出血组顺产、器械助产、脐带绕颈（NC）和脐带扭转（UCT）的构成比高于对照组,分别为（72.9%∶66%）、（4.5%∶2.7%）、（29.1%∶20.2%）和（13.06%∶5.62%）;剖宫产的构成比则低于对照组（22.6%∶31.3%）,差异有统计学意义（P〈0.05）。多因素logistic回归分析提示：顺产、器械助产、NC和UCT是新生儿视网膜出血的危险因素。结论 新生儿视网膜出血的危险因素涉及顺产、器械助产、NC和UCT等多方面,应引起相关临床医师的重视。（中国眼耳鼻喉科杂志,2016,16：255-257）Objective To study the risk factors of retinal hemorrhage in healthy full-term newborns. Methods A total of 1 017 full-term newborns with gestational age more than 37 weeks born in the Fourth Hospital of Shijiazhuang between December 2014 and July 2015 were included in the study. The clinical data such as gender, parity,birth weight, gestational hypertension, gestational diabetes mellitus, delivery mode, nuchal cord and umbilical cord torsion were observed. Newborns were divided into retinal hemorrhage group and the control group. Ocular fundus examination with RetCam Ⅲ were performed in all newborns within 15 days of birth. The potential risk factors of retinal hemorrhage were analyzed statistically. Results Retinal hemorrhage was found in 199 cases （ 19.6% ）. The significantly higher proportion of spontaneous normal delivery（72.9% vs 66% ）, forces delivery（4.5% vs 2.7% ）, nuchal cord（29.1% vs 20.2% ） and umbilical cord torsion（ 13.06% vs 5.62% ）, and lower prevalence of cesarean delivery （22.6% vs 31.3% ） were observed in retinal hemorrhage group. Conclusions Spontaneous normal delivery, forces delivery, nuchal cord and umbilical cord torsion were the potential risk factors for the retinal hemorrhage in full-term newborns. Newborns with these risk factors may, therefore, require greater attention to retinal hemorrhage.

关 键 词：脐带绕颈 脐带扭转 足月新生儿 视网膜出血 

分 类 号：R774.1[医药卫生—眼科]