乐清地区新生儿视网膜出血及其影响因素分析  

Analysis of Neonatal Retinal Hemorrhage and Its Influencing Factors in Yueqing Area

作　　者：曹凯乐 潘建东 陈峰 Cao Kai-le;Pan Jian-dong;Chen Feng(Department of Ophthalmology,The Sixth People's Hospital Of Jiujiang,Jiujiang 332001,China)

机构地区：[1]江西省九江市第六人民医院眼科,332001 [2]温州医科大学附属眼视光医院

出　　处：《中国斜视与小儿眼科杂志》2020年第4期32-35,I0009,共5页Chinese Journal of Strabismus & Pediatric Ophthalmology

摘　　要：目的观察新生儿视网膜出血的眼底特征并对其影响因素进行分析。方法1336名新生儿(2672眼)纳入研究。使用广域数字化眼底成像系统于出生后平均(3.67±0.91)天对新生儿行眼底检查。结果1336名新生儿(2672眼),发生视网膜出血197例(14.75%),322眼(12.05%)。以散在视网膜浅层圆点状出血多见。其中双眼出血125例(63.45%)、单眼出血72例(36.55%)。Ⅰ、Ⅱ区合并出血317眼,占98.45%;Ⅱ、Ⅲ区合并出血295眼,占91.61%;Ⅰ、Ⅱ、Ⅲ区合并出血291眼,占90.37%。仅Ⅰ区出血1眼,占0.31%;无单独Ⅱ区及Ⅲ区出血者。无Ⅰ级出血眼;Ⅱ级出血34眼,占10.56%;Ⅲ级出血288眼,占89.44%。197例视网膜出血新生儿中有67例于1个月后复查,视网膜出血均已吸收完全;不同性别、不同产次、不同胎龄的视网膜出血发生率无统计学差异。自然分娩与产钳助产视网膜出血发生率间无统计学差异。自然分娩及产钳助产视网膜出血发生率均高于剖腹产新生儿(P<0.001);Logistic回归分析提示视网膜出血的相关危险因素为分娩方式、年龄。结论新生儿视网膜出血大多双眼发病,多集中在Ⅰ、Ⅱ区,以Ⅲ级出血为主,均为浅层视网膜出血;出血可在1个月内吸收;自然分娩及产钳助产可增加新生儿视网膜出血发生率;性别、产次、胎龄等因素对视网膜出血发生率无影响。Objective To observe and analyze the fundus characteristics of neonatal retinal hemorrhage and its influencing factors.Methods 2672 eyes of 1336 newborns were included in the study.And the wide area digital fundus imaging system(RetCamⅢ)was used to examine the fundus of newborns on an average of 3.67±0.91 days after birth.Results In2672 eyes of 1336 newborns,retinal hemorrhage occurred in 197 cases(14.75%),322 eyes(12.05%).The most common hemorrhage was scattered dotted hemorrhage in the superficial layer of the retina.There were 125 cases of binocular hemorrhage(63.45%)and 72 cases of monocular hemorrhage(36.55%).Further analysis showed that for zoning,hemorrhage occurred in 317 eyes(98.45%)in areasⅠandⅡ;295 eyes(91.61%)in areasⅡandⅢ;and 291 eyes(90.37%)in areasⅠ,ⅡandⅢ.There was only one eye bleeding in areaⅠ(0.31%);and there was no bleeding in areaⅡand areaⅢalone.For bleeding grading,there were no gradeⅠbleeding eyes;gradeⅡbleeding in 34 eyes(10.56%);and gradeⅢbleeding in 288 eyes(89.44%).67 of the 197 newborns with retinal hemorrhage were reexamined after 1 month,and the retinal hemorrhage was completely absorbed;in addition,there was no significant difference in the incidence of retinal hemorrhage between different genders,different parities and different gestational ages.There was no obvious difference in the incidence of retinal hemorrhage between natural delivery and forceps delivery,but they were both higher than that in newborns delivered by caesarean section(P<0.001).Logistic regression analysis showed that the related risk factors of retinal hemorrhage were delivery mode and age.Conclusion Most of the neonatal retinal hemorrhage occurred in both eyes,at the same time,mostly concentrated in areaⅠandⅡ,mainly gradeⅢ,and all of which were superficial retinal hemorrhage;the hemorrhage could be absorbed within 1 month.Natural delivery and forceps delivery can increase the incidence of neonatal retinal hemorrhage,while gender,parity,gestational age and other factors have no

关 键 词：新生儿视网膜出血 危险因素 广域数字化眼底成像系统 

分 类 号：R774.1[医药卫生—眼科] R722.1[医药卫生—临床医学]