玻璃体腔注射康柏西普治疗早产儿视网膜病变的临床疗效  

Effects of Intravitreal Injection of Compaq Spray for the Treatment of Retinopathy of Prematurity

作　　者：申战省[1] 陈梦平[1] 李娴 王学忠 颜华[4] Zhansheng Shen;Mengping Chen;Xian Li;Xuezhong Wang;Hua Yan(Zhengzhou Second People's Hospital,Zhengzhou 450000,China;Henan Children's Hospital,Zhengzhou 450000,China;Dengfeng Maternal and Child Health Hospital,Zhengzhou 452470,China;Tianjin Medical University,Tianjin 300070,China)

机构地区：[1]郑州市第二人民医院郑州市眼科医院,450000 [2]河南省儿童医院,郑州450000 [3]登封市妇幼保健院,郑州452470 [4]天津医科大学,300070

出　　处：《中华眼视光学与视觉科学杂志》2020年第2期143-147,共5页Chinese Journal Of Optometry Ophthalmology And Visual Science

摘　　要：目的:观察玻璃体腔注射康柏西普治疗早产儿视网膜病变(ROP)的安全性和有效性。方法:回顾性系列病例研究。选择2015年2月至2016年5月在郑州市第二人民医院和登封市妇幼保健院行ROP筛查并诊断为急进性后极部早产儿视网膜病变(AP-ROP)、阈值期ROP或阈值前期1型ROP的患儿26例(52眼)。其中Ⅰ区病变17例,Ⅱ区病变9例。所有患儿在确诊后24 h内玻璃体腔注射10 mg/ml康柏西普0.025 ml(含康柏西普0.25 mg)。随访时间为21~49(31.2±12.5)周。病情复发或对康柏西普治疗无反应者,给予重复康柏西普注射或激光光凝治疗。随访期间观察患儿视网膜血管变化情况以及眼部或全身不良反应。结果:52眼中,经单次康柏西普治疗有效为46眼(88%),病变完全消退,视网膜血管发育至Ⅲ区。重复康柏西普注射治疗2眼,占4%;经补充激光光凝治疗4眼,占8%。3眼病变复发,占所有患眼的6%,纤维增生膜持续加重,发生视网膜脱离行玻璃体切割术,2眼术后视网膜完全复位,1眼术后视网膜部分复位,包括AP-ROP 1眼,阈值期ROP 2眼,均为Ⅱ区病变,复发时间为10~17(13.2±1.8)周。所有患儿随访期间均未发生局部及全身不良反应。结论:康柏西普注射治疗ROP患儿安全有效。部分治疗无反应者,需手术联合激光光凝治疗。Objective:To observe the safety and efficacy of the vitreous cavity injection of compaq for the treatment of retinopathy of prematurity(ROP).Methods:This was a retrospective case study.Twenty-six children(52 eyes)with acute posterior premature retinopathy(AP-ROP),threshold ROP or pre-threshold ROP were diagnosed by ROP screening in Zhengzhou Second People's Hospital and Dengfeng Maternal and Child Health Hospital from February 2015 to May 2016.Seventeen cases(34 eyes)of levelⅠlesions and 9 cases(18 eyes)of levelⅡlesions were found.All the children were injected with 10 mg/ml of compaq 0.025 ml(0.25 mg)into the vitreous chamber within 24 h of the diagnosis.The follow-up time was 21-49 weeks with a mean follow-up time of 31.2±12.5 weeks.If there was a disease relapse or no response to treatment with compaq,patients were treated with a repeated compaq injection or laser photo-coagulation.The changes in the retinal vessels of the children were followed and adverse events of the eye or body were monitored.Results:In the 52 eyes,a total of 46 eyes had completerecedingdue toasingle dose of compaq,accounting for 88%.The lesion disappeared completely and the retinal vessels developed to levelⅢ.Two eyes were treated with a repeated compaq injection(4%)and 4 eyes were treated with supplementary laser photocoagulation(8%).Among these,three eyes were treated with vitrectomy,accounting for 6%of all eyes.In these eyes,the fibroproliferative membrane continued to aggravate,retinal detachment occurred,the retina completely resetin 2 eyes,and there was a partial reposition of the retina in one eye after vitrectomy.This one eye had AP-ROP.Two eyes had threshold ROP with lesions at levelⅡ.Recurrence times were 10-17 weeks with an average recurrence time of 13.2±1.8 weeks.No adverse reactions were observed during the follow-up period.Conclusions:Intraocular injection of compaq is safe and effective in the treatment of children with ROP.Surgery combined with laser photocoagulation is necessary for some unresponsive patients.

关 键 词：早产儿视网膜病变 康柏西普 玻璃体腔注射 并发症 疗效 

分 类 号：R77[医药卫生—眼科]