1006例NICU早产儿ROP发病率及危险因素分析  

Incidence and risk factors of ROP in 1006 premature infants admitted to NICU

作　　者：帅少帅 谭荣强[1] 袁桂亮 Shuai Shaoshuai;Tan Rongqiang;Yuan Guiliang(Department of Ophthalmology,Zhaoqing First People s Hospital,Zhaoqing,Guangdong 526000,China)

机构地区：[1]肇庆市第一人民医院眼科,广东肇庆526000

出　　处：《广州医科大学学报》2022年第3期63-69,共7页Academic Journal of Guangzhou Medical University

基　　金：肇庆市科技创新指导类项目(200429094163198)。

摘　　要：目的:探究1006例NICU早产儿视网膜病变(ROP)发病率及危险因素。方法:选取2020年1月~2021年4月在肇庆市第一人民医院出生1006例(2012只眼)早产儿作为研究对象,所有早产儿在住院期间均接受眼底筛查,判断是否存在视网膜病变的情况,记录早产儿胎龄、出生体重、吸氧、保温箱、贫血等及妊娠期并发症、围产期感染、激素使用、分娩方式等相关信息,通过单因素和多因素分析,筛查早产儿ROP发病的高危因素。结果:1006例(2012只眼)早产儿中有135例(141只眼)发现存在ROP的情况,其中6例患儿双眼均有ROP发生,发生率为135/1006(13.42%);经单因素分析显示,胎儿的出生体重、胎龄、有吸氧、肺炎、低血糖、败血症、呼吸暂停、吸氧时间等与ROP发病相关(P<0.05);母亲的吸烟、胎膜早破、妊娠期高血压、产前激素的应用、围产期感染、贫血、输血史等与ROP发病相关(P<0.05);多因素Logistic回归分析显示,胎儿出生体重和胎龄是ROP的保护因素(P<0.05),胎儿吸氧(OR=3.432)、低血糖(OR=1.399)、呼吸暂停(OR=3.721)、吸氧时间(OR=3.438)及母亲吸烟(OR=4.914)、妊娠期高血压(OR=1.645)、围产期感染(OR=3.511)是ROP的危险因素(P<0.05);出生体重、分娩方式是影响患者疾病严重程度的因素(P<0.05)。结论:胎儿出生体重低、胎龄小、吸氧、低血糖、呼吸暂停、吸氧时间长及母亲吸烟、妊娠期并发症、围产期感染等是ROP发生的危险因素,临床上加强对早产儿的眼底筛查与治疗,有利于降低ROP的发生,帮助患儿控制病情,减少失明情况的发生。Objective:To investigate the incidence and risk factors of retinopathy of prematurity(ROP)in 1006 premature infants admitted to NICU.Methods:A total of 1006 premature infants(2012 eyes)born in Zhaoqing First People s Hospital between January 2020 and April 2021 were included as study subjects.All premature infants underwent fundus screening for ROP during their hospitalization.The gestational age,birth weight,oxygen therapy,incubator use,anemia,complications during pregnancy,perinatal infection,hormone administration,and mode of delivery were recorded for premature infants.Risk factors of ROP in the premature infants were determined by univariate and multivariate analyses.Results:ROP was found in 135(141 eyes)out of 1006(2012 eyes)premature infants,including 6 infants with ROP in both eyes,with an incidence rate of 135/1006(13.42%).Univariate analysis showed that fetal birth weight,gestational age,oxygen inhalation,pneumonia,hypoglycemia,sepsis,apnea,and duration of oxygen inhalation were associated with occurrence of ROP(P<0.05).Maternal smoking,premature rupture of membrane,gestational hypertension,prenatal use of hormones,perinatal infection,anemia,and history of blood transfusion were also associated with ROP(P<0.05).Multivariate Logistic regression analysis showed that fetal birth weight and gestational age were protective factors for ROP(P<0.05),while fetal oxygen inhalation(OR=3.432),hypoglycemia(OR=1.399),apnea(OR=3.721),duration of oxygen inhalation(OR=3.438),maternal smoking(OR=4.914),gestational hypertension(OR=1.645),and perinatal infection(OR=3.511)were risk factors for ROP(P<0.05).Birth weight and delivery mode were influential factors of ROP severity(P<0.05).Conclusion:Low birth weight,small gestational age,oxygen inhalation,hypoglycemia,apnea,prolonged oxygen inhalation,maternal smoking,complications during pregnancy,and perinatal infection are risk factors for ROP.Attention to fundus screening and treatment can help reduce and contain ROP,and avert the onset of blindness.

关 键 词：新生儿 早产儿视网膜病变 发生率 发病风险 危险因素 

分 类 号：R722.1[医药卫生—儿科]