乌鲁木齐市新生儿视网膜出血结果分析  

Analysis of neonatal retinal hemorrhage in Urumqi

作　　者：刘子江 卡比努尔 马平 赵静 美菊德 魏碧霞 郑策 乔彤 Liu Zi-jiang;Kabinur;Ma Ping(Urumqi maternal and Child,Health Hospital,Urumqi 830000,China)

机构地区：[1]乌鲁木齐市妇幼保健院,830000 [2]乌鲁木齐市儿童医院 [3]上海交通大学附属儿童医院

出　　处：《中国斜视与小儿眼科杂志》2020年第3期30-33,共4页Chinese Journal of Strabismus & Pediatric Ophthalmology

基　　金：乌鲁木齐市卫健委科技计划项目(编号:201813)。

摘　　要：目的应用广域数字化眼底成像系统(RetCam3)对乌鲁木齐市新生儿眼底进行筛查分析,为新疆新生儿眼科数据库相关知识做出补充及提供参考。方法对乌鲁木齐市妇幼保健院2017年1月至2018年12月出生的12656例新生儿(25312眼)应用RetCam3进行眼底筛查并照相。记录所有受检新生儿出生孕周、出生体重、分娩方式等临床资料,对结果进行分析。对筛查异常者根据情况复诊,需治疗者及时治疗或转诊。结果12656例新生儿(25312眼)中,视网膜出血者1689例(2764眼,左眼1384,右眼1380;双眼视网膜出血1075例,单眼视网膜出血614例)占13.35%。视网膜出血的分娩方式、出生胎龄、出生体重及民族与非视网膜出血的差异有统计学意义(依次χ~2=1015.011,P<0.001;χ~2=163.590,P<0.001;χ~2=119.367,P<0.001;χ~2=32.130,P<0.001)。顺产新生儿视网膜出血的可能是剖宫产的9.943倍,OR 95%CI(8.386~11.876);正常体重新生儿视网膜出血的可能是低体重的2.235倍,OR 95%CI(1.479~3.455);足月儿视网膜出血的可能是早产儿的2.339倍,OR 95%CI(1.695~3.293);回族新生儿视网膜出血的可能是哈萨克族的2.741倍,OR95%CI(2.431-5.260)。剖宫产、低体重、早产儿及哈萨克族相比于回族是新生儿视网膜出血的保护因素。结论新生儿眼病发生率占一定比例,需从源头抓起,早发现早治疗,可以自愈的眼病密切观察随诊,对减少可避免盲的发生有积极意义。Objective To use the wide-area digital fundus imaging system(RetCam3)to screen and analyze the neonatal fundus in Urumqi,Xinjiang,and to provide a reference for the relevant knowledge of Xinjiang neonatal ophthalmology database.Methods RetCam3 was used for fundus screening and photography of 12656 newborns(25312 eyes)born in January 2017 to December 2018 in Urumqi Maternal and Child Health Hospital of Xinjiang.Record all the clinical data of the gestational age,birth weight,delivery method and other births of the children examined,and analyze the results.Patients with abnormal screening will be reviewed according to the situation,and those who need treatment will be treated or referred in time.Results Among 12656 newborns(25312 eyes),1689(2764 eyes,1384 left eyes,1380 right eyes,1075 binocular and 614 monocular)accounted for 13.35%of patients with retinal hemorrhage.There were statistically significant differences in the delivery methods,gestational age,birth weight,ethnicity and non-retinal hemorrhage of retinal hemorrhage(χ~2=1015.011,P<0.001;χ~2=163.590,P<0.001;χ~2=119.367,P<0.001;χ~2=32.130,P<0.001).The possibility of retinal bleeding in neonates with normal delivery is 9.943 times that of cesarean section,OR95%CI(8.386~11.876);the probability of retinal bleeding in normal-weight newborns is 2.235 times that of low weight,OR 95%CI(1.479~3.455);Retinal hemorrhage in full-term infants may be 2.339 times that of premature infants,OR 95%CI(1.695~3.293);The possibility of retinal hemorrhage in Hui neonates is 2.741 times that of Kazakhs,OR 95%CI(2.431~5.260).Cesarean section,low birth weight,premature infants and Kazakhs are the protective factors of neonatal retinal hemorrhage compared with Hui.Conclusion The incidence of neonatal ophthalmopathy accounts for a certain proportion.It needs to be grasped from the source.Early detection and early treatment.The self-healing ophthalmopathy can be closely observed and followed up,which has a positive significance in reducing the occurrence of avoidable blindness.

关 键 词：新生儿 视网膜出血 眼底筛查 RetCam3 

分 类 号：R774.1[医药卫生—眼科]