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一种在发展中国家降低早产儿视网膜病变致盲率的实用方法。

A practical method for reducing blindness due to retinopathy of prematurity in a developing country.

机构信息

Instituto Damos Vision, Lima, Peru.

出版信息

J Perinat Med. 2012 Sep 4;40(5):577-82. doi: 10.1515/jpm-2011-0225.

Abstract

BACKGROUND

Retinopathy of prematurity (ROP) is a common cause of blindness in countries with rapidly developing systems of neonatal care. At present, detection and treatment programs are not widely available in many regions of middle- and low-income countries. SUBJECT POPULATION: Case series.

METHODS

An analysis was undertaken to determine in which neonatal intensive care units (NICUs) in Peru babies blind from ROP had been cared for. Demographic and hospital information was gathered for children blind from ROP presenting before the age of 5 years. NICUs with a high likelihood of having ROP-blind children were offered training and equipment designed to improve neonatal care.

RESULTS

Ninety-one children with ROP blindness were identified. Twenty-six percent were <1000 g at birth, and 17% had birth weights of >1500 g. Forty-six percent came from NICUs in Lima. Interventional workshops emphasizing neonatal care and oxygen administration have been conducted thus far in six of the 13 largest NICUs in Lima. The percentage of at-risk babies being examined has generally increased, whereas the percentage of babies requiring treatment decreased in three NICUs and increased slightly in two, and no preworkshop data were available in one.

CONCLUSION

This report represents the initial results of an evidence-based approach to decreasing blindness from ROP in Peru. Workshops emphasizing neonatal care, especially targeting oxygen administration, provide methods for improving care of at-risk babies.

摘要

背景

早产儿视网膜病变(ROP)是新生儿护理体系快速发展的国家中导致失明的常见原因。目前,许多中低收入国家的许多地区尚未广泛开展ROP 的检测和治疗项目。

研究对象

病例系列。

方法

对秘鲁哪些新生儿重症监护病房(NICU)收治过因 ROP 失明的婴儿进行了分析。对在 5 岁前出现 ROP 失明的儿童收集了人口统计学和医院信息。为那些极有可能收治 ROP 失明儿童的 NICU 提供了旨在改善新生儿护理的培训和设备。

结果

共发现 91 名 ROP 失明儿童。26%的患儿出生体重<1000g,17%的患儿出生体重>1500g。46%的患儿来自利马的 NICU。迄今为止,在利马的 13 家最大的 NICU 中的 6 家已经开展了强调新生儿护理和氧管理的干预性研讨会。一般来说,接受检查的高危婴儿比例有所增加,而需要治疗的婴儿比例在 3 家 NICU 中略有下降,在 2 家 NICU 中略有上升,而在 1 家 NICU 中没有会前数据。

结论

本报告代表了秘鲁通过循证方法降低 ROP 致盲率的初步结果。强调新生儿护理,特别是针对氧管理的研讨会,提供了改善高危婴儿护理的方法。

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