双目间接检眼镜在基层医院早产儿视网膜病变筛查中的应用  

Application of Binocular Indirect Ophthalmoscope in Screening Retinopathy of Prematurity in Primary Hospital

作　　者：蔡福旭[1] 张曾晟 CAI Fuxu;ZHANG Zengsheng(Department of Ophtalmology,Affiliated Hospital of Putian University,Putian Fujian 351100,China)

机构地区：[1]莆田学院附属医院眼科,福建莆田351100

出　　处：《中国卫生标准管理》2023年第3期40-44,共5页China Health Standard Management

摘　　要：目的分析双目间接检眼镜在基层医院早产儿视网膜病变筛查中的应用价值。方法选取2018年5月—2022年5月莆田学院附属医院的409例早产儿为研究对象,对所有早产儿应用双目间接检眼镜筛查其视网膜情况,并将最终的临床诊断结果作为“金标准”,统计分析双目间接检眼镜筛查早产儿视网膜病变的符合情况,并对双目间接检眼镜筛查早产儿视网膜病变的特异性、灵敏度进行计算。结果409例早产儿最终经“金标准”诊断有72例、72眼视网膜病,视网膜病变率为17.60%。其中,视网膜病变Ⅲ区Ⅰ期者8例8眼,Ⅲ区Ⅱ期者2例2眼,Ⅲ区Ⅲ期者4例4眼,无Ⅳ期或Ⅴ期病变。本次双目间接检眼镜筛查共计检出74例视网膜病变,双目间接检眼镜筛查符合率为95.60%(391/409),筛查特异性为97.03%(327/337),筛查灵敏度为88.89%(64/72)。双目间接检眼镜具有较高的筛查准确率,与“金标准”相比,在视网膜病变诊断及视网膜病变分类的筛查中数据差异无统计学意义(P>0.05)。检查期间发现有2例早产儿头皮下存在较多的出血点,2例2眼有不同程度的急性结膜炎,7例7眼存在一定的球结膜下出血。45例患儿家属诉患儿筛查后睡觉时常有惊叫。检查后没有出现休克、呼吸暂停等严重并发症。结论双目间接检眼镜在基层医院早产儿视网膜病变筛查中具有良好的应用效果,能够较为准确的筛查视网膜病变以及对病变进行分型。Objective To analyze the application value of binocular indirect ophthalmoscope in screening retinopathy of prematurity in primary hospitals.Methods A total of 409 premature infants in Affiliated Hospital of Putian University from May 2018 to May 2022 were selected as research objects.The coincidence of binocular indirect ophthalmoscope screening for retinopathy of prematurity was analyzed statistically,and the specific sensitivity of binocular indirect ophthalmoscope screening for retinopathy of prematurity was calculated.Results In this group of 409 premature infants,72 cases and 72 eyes were finally diagnosed with retinopathy by the"gold standard",and the retinopathy rate was 17.60%.There were 8 eyes of 8 patients with stageⅢretinopathy,2 eyes of 2 patients with stageⅢretinopathy,4 eyes of 4 patients with stageⅢretinopathy,and no stageⅣorⅤretinopathy.A total of 74 cases of retinopathy were detected by binocular indirect ophthalmoscope screening.The screening coincidence rate was 95.60%(391/409),the screening specificity was 97.03%(327/337),and the screening sensitivity was 88.89%(64/72).Binocular indirect ophthalmoscope had a high screening accuracy.Compared with the"gold standard",there was no significant difference in the screening data of retinopathy diagnosis and retinopathy classification(P>0.05).Two cases(2 eyes)had different degrees of acute conjunctivitis,and 7 cases(7 eyes)had certain subconjunctival hemorrhage.The family members of 45 children complained that the children often screamed during sleep after screening.There were no serious complications such as shock and apnea after examination.Conclusion Binocular indirect ophthalmoscope has a good application effect in screening retinopathy of prematurity in primary hospitals,which can be more accurate screening and classification of retinopathy.

关 键 词：双目间接检眼镜 基层医院 早产儿 视网膜病变 筛查 应用价值 

分 类 号：R774[医药卫生—眼科]