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巴西南部预防早产儿视网膜病变所致失明项目的结果

Results of a program for the prevention of blindness caused by retinopathy of prematurity in southern Brazil.

作者信息

Fortes Filho João Borges, Barros Cristiano Koch, da Costa Marlene Coelho, Procianoy Renato S

机构信息

Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.

出版信息

J Pediatr (Rio J). 2007 May-Jun;83(3):209-16. doi: 10.2223/JPED.1611. Epub 2007 Apr 23.

DOI:10.2223/JPED.1611
PMID:17486199
Abstract

OBJECTIVE

To describe the results of a program for the prevention of blindness caused by retinopathy of prematurity implemented in 2002 at a tertiary-care hospital, according to screening criteria adopted in Brazil, and to compare some aspects with the criteria adopted by other countries.

METHODS

Descriptive observational study including all preterm infants born at this hospital weighing <or= 1,500 g at birth and/or gestational age <or= 32 weeks who survived up to the sixth week after birth, between October 2002 and June 2006. Ophthalmic examinations were performed from the sixth week of life and repeated as necessary until remission of the disease.

RESULTS

A total of 300 newborns were included and there were 18 cases of treatable threshold disease (18/300, 6%) according to the Brazilian criteria. One patient was not treated because s/he developed the disease after hospital discharge and did not turn up for examination in order to initiate treatment. According to the criteria suggested by industrialized countries, the total number of exams would be reduced under the same circumstances, but 11.76% of the cases of threshold disease would not be detected.

CONCLUSIONS

The Brazilian criteria for neonatal screening were efficient in detecting treatable cases. Blindness was averted in 17 preterm infants in the study period. The universal use of such program at teaching hospitals or in the public and private health networks could help prevent one of the main causes of preventable and treatable blindness among infants in developing countries. Currently, a change in these criteria in Brazil may compromise the diagnosis of some treatable patients.

摘要

目的

根据巴西采用的筛查标准,描述2002年在一家三级医院实施的预防早产儿视网膜病变所致失明项目的结果,并将某些方面与其他国家采用的标准进行比较。

方法

描述性观察研究,纳入2002年10月至2006年6月期间在本院出生、出生体重≤1500g和/或胎龄≤32周且存活至出生后第六周的所有早产儿。从出生后第六周开始进行眼科检查,并根据需要重复检查,直至疾病缓解。

结果

共纳入300例新生儿,根据巴西标准,有18例可治疗的阈值疾病(18/300,6%)。1例患者未接受治疗,因为其在出院后患病且未前来检查以开始治疗。根据工业化国家建议的标准,在相同情况下检查总数会减少,但11.76%的阈值疾病病例将无法被检测到。

结论

巴西新生儿筛查标准在检测可治疗病例方面是有效的。在研究期间,17例早产儿避免了失明。在教学医院或公共及私人卫生网络中普遍使用此类项目有助于预防发展中国家婴儿可预防和可治疗失明的主要原因之一。目前,巴西这些标准的改变可能会影响一些可治疗患者的诊断。

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