早产儿视网膜病变的综合管理  

Comprehensive management of retinopathy of prematurity

作　　者：王旌(综述)[1,2,3,4] 童晓维(审校) WANG Jing;TONG Xiaowei(Shanghai Eye Diseases Prevention&Treatment Center/Department of Ophthalmology,Shanghai Eye Hospital,Shanghai 200040;National Clinical Research Center for Eye Diseases,Shanghai 200040;Shanghai Key Laboratory of Ocular Fundus Diseases,Shanghai 200080;Department of Ophthalmology,Shanghai General Hospital,Shanghai 200080,China)

机构地区：[1]上海市眼病防治中心/上海市眼科医院眼科,上海200040 [2]国家眼部疾病临床医学研究中心,上海200040 [3]上海市眼底病重点实验室,上海200080 [4]上海市第一人民医院眼科,上海200080

出　　处：《眼科学报》2020年第6期382-390,共9页Eye Science

基　　金：上海市卫生和计划生育委员会青年课题(20144Y0212)。

摘　　要：早产儿视网膜病变(retinopathy of prematurity,ROP)是全世界儿童失明的主要原因。ROP的综合管理方案以视网膜新生血管(retinal neovascularization,RNV)为核心,在第一阶段通过适度的低氧流量促进生理性视网膜血管化,预防RNV;在第二阶段通过规范的ROP筛查和随访监测RNV,并通过消融周边视网膜无血管区以及玻璃体腔内抗血管内皮生长因子治疗控制RNV;在第三阶段通过手术治疗解除RNV纤维化血管造成的牵引性视网膜脱离。基于循证医学理论的ROP综合管理,可以对RNV进行预防、监测、控制和处理并发症,从而有效降低儿童失明的比例。Retinopathy of prematurity(ROP)is the leading cause of blindness in children all over the world.Comprehensive management of ROP focuses on retinal neovascularization(RNV).In the first phase,moderate oxygen flow is used to promote physiological retinal vascularization and prevent RNV.In the second phase,RNV is monitored by standard ROP screening and follow-up and is controlled by ablation of peripheral avascular retina and intravitreal anti-vascular endothelial growth factor treatment.In the third phase,tractional retinal detachment caused by RNV vascular fibrosis is managed by surgery.Comprehensive management of ROP based on evidence-based medicine can prevent,monitor,control and manage the complications of RNV,thus effectively reducing the proportion of blindness in children.

关 键 词：早产儿视网膜病变 视网膜新生血管 血管内皮生长因子 

分 类 号：R72[医药卫生—儿科]