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早产儿视网膜病变的危险因素及激光治疗在新生儿重症监护病房。

Risk factors and laser therapy for retinopathy of prematurity in neonatal intensive care unit.

机构信息

Department of Neonatology, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, 710061, China.

出版信息

World J Pediatr. 2009 Nov;5(4):304-7. doi: 10.1007/s12519-009-0058-6. Epub 2009 Nov 13.

DOI:10.1007/s12519-009-0058-6
PMID:19911148
Abstract

BACKGROUND

With the increasing survival rates of preterm infants, the incidence of retinopathy of prematurity (ROP) is also increasing. This study aimed to investigate the risk factors for ROP in Neonatal Intensive Care Unit, and the effects of laser therapy.

METHODS

Thirty-five premature infants with various other diseases were studied. Data were collected including gender, gestational age, birth weight, maternal gravidity, Apgar score, antenatal and postnatal hypoxia, anemia, jaundice, infection, pregnancy complications, and head ultrasound manifestations. All patients were subjected to fundus examinations at a postmenstrual age of 34 weeks using an indirect ophthalmoscope. The infants were divided into ROP group and non-ROP group. Infants with ROP received laser treatment. The data of the infants were analyzed using univariate analysis and the logistic regression model.

RESULTS

Twenty-seven (77.1%) of the 35 infants had ROP and 21 of them also had plus diseases. The recovery rates were 74.1% and 92.6% at 2 weeks and 3 months after laser therapy, respectively. The birth weight and gestational age in the ROP group were significantly lower than those in the non-ROP group (P<0.01). The lower the gestational age and birth weight, the higher the incidence of ROP. There was a significant difference in the incidence of ROP with postnatal hypoxia (P=0.013), anemia (P=0.012) and gravidity two (P<0.05), analyzed with the Fisher's exact probability test (P<0.05). The gestational age was significantly lower in the plus disease group than in the non-plus disease group (P<0.05).

CONCLUSIONS

The incidence of ROP is high in premature infants with various other diseases and is correlated with birth weight, gestational age, postnatal hypoxia, anemia and maternal gravidity. Laser therapy shows good outcomes.

摘要

背景

随着早产儿存活率的提高,早产儿视网膜病变(ROP)的发病率也在增加。本研究旨在探讨新生儿重症监护病房(NICU)ROP 的危险因素,以及激光治疗的效果。

方法

研究了 35 例患有其他各种疾病的早产儿。收集的数据包括性别、胎龄、出生体重、产妇孕次、阿普加评分、产前和产后缺氧、贫血、黄疸、感染、妊娠并发症和头部超声表现。所有患者在胎龄 34 周后使用间接检眼镜进行眼底检查。根据是否患有 ROP 将患儿分为 ROP 组和非 ROP 组。ROP 患儿接受激光治疗。使用单因素分析和逻辑回归模型对患儿数据进行分析。

结果

35 例患儿中 27 例(77.1%)患有 ROP,其中 21 例患儿还患有其他疾病。激光治疗后 2 周和 3 个月的治愈率分别为 74.1%和 92.6%。ROP 组的出生体重和胎龄明显低于非 ROP 组(P<0.01)。胎龄和出生体重越低,ROP 的发生率越高。经 Fisher 确切概率检验,发现与 ROP 发生率相关的因素有产后缺氧(P=0.013)、贫血(P=0.012)和孕次 2 次(P<0.05)。经 Fisher 确切概率检验,有合并症组的胎龄明显低于无合并症组(P<0.05)。

结论

患有其他各种疾病的早产儿 ROP 发病率较高,与出生体重、胎龄、产后缺氧、贫血和产妇孕次有关。激光治疗效果良好。

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