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中国早产儿视网膜病变防治的系统研究。

A systematic study on the prevention and treatment of retinopathy of prematurity in China.

作者信息

Xu Shuman, Liang Zhijiang, Du Qiyun, Li Zhankui, Tan Guangming, Nie Chuan, Yang Yang, Lv Xuzai, Zhang Chunyi, Luo Xianqiong

机构信息

Guangdong Women and Children Hospital, 521 Xingnan Road, Guangzhou, Guangdong, 511442, People's Republic of China.

Hunan Women and Children Hospital, Changsha, Hunan, People's Republic of China.

出版信息

BMC Ophthalmol. 2018 Feb 14;18(1):44. doi: 10.1186/s12886-018-0708-3.

Abstract

BACKGROUND

To identify the prevention situation, the main factors influencing prevention effects and to develop control measures over retinopathy of prematurity in China.

METHODS

Using stratified random sampling method, we randomly selected 23 provincial and ministerial hospitals (8 in Guangdong province, 5 in Hunan province and 10 in Shaanxi province), 81 municipal hospitals (38 in Guangdong province, 19 in Hunan province and 24 in Shaanxi province), 180 district and county hospitals (76 in Guangdong province, 57 in Hunan province and 47 in Shaanxi province) in China. A total of 284 hospitals were enrolled in the study, with questionnaires distributed investigating the status and constrain factors of ROP presentation. Significant outcomes were analyzed thereafter by SPSS 19.0.

RESULTS

The screening rate of ROP in medical institutions from eastern, central and western China were 84.6%, 35.0% and 56.7%, respectively. The screening rate of tertiary and secondary medical institutions were 84.6% and 25.7% in the eastern, 35.0% and 4.9% in the central, 56.7% and 5.9% in the western region. Screening was carried out better in the tertiary than that in the secondary and primary institutions. Treatment for ROP was available in 15.7% of all the tertiary hospitals surveyed. Lack of professionals, equipments and technologies were considered to be major restrain factors for screening.

CONCLUSIONS

The ROP screening and treatment status have demonstrated significant regional diversity due to uneven distribution of medical resources in China. Developed areas had established intraregional cooperation models, whereas less-developed areas should consider set up a large-scale, three-level ROP prevention network. It is of paramount importance that education and training towards ophthalmologists should be vigorously strengthened. It is strongly recommended that implement ROP telemedicine and integrated ROP prevention and management platforms through the Internet should be established.

摘要

背景

了解我国早产儿视网膜病变的防治现状、影响防治效果的主要因素并制定防控措施。

方法

采用分层随机抽样方法,在中国随机选取23家省部属医院(广东省8家、湖南省5家、陕西省10家)、81家市级医院(广东省38家、湖南省19家、陕西省24家)、180家区县医院(广东省76家、湖南省57家、陕西省47家)。共284家医院纳入研究,发放问卷调查早产儿视网膜病变的防治现状及制约因素。之后采用SPSS 19.0软件对有效结果进行分析。

结果

我国东、中、西部地区医疗机构早产儿视网膜病变筛查率分别为84.6%、35.0%和56.7%。东部地区三级和二级医疗机构筛查率分别为84.6%和25.7%,中部地区分别为35.0%和4.9%,西部地区分别为56.7%和5.9%。三级医疗机构筛查工作开展情况优于二级和一级医疗机构。在接受调查的所有三级医院中,15.7%的医院能够开展早产儿视网膜病变治疗。专业人员、设备和技术缺乏被认为是筛查的主要制约因素。

结论

由于我国医疗资源分布不均衡,早产儿视网膜病变筛查和治疗现状呈现出显著的地区差异。发达地区已建立区域内合作模式,而欠发达地区应考虑建立大规模的三级早产儿视网膜病变防治网络。大力加强眼科医生的教育和培训至关重要。强烈建议通过互联网实施早产儿视网膜病变远程医疗并建立综合性早产儿视网膜病变防治管理平台。

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Telemedicine for retinopathy of prematurity.早产儿视网膜病变的远程医疗。
Curr Opin Ophthalmol. 2013 Sep;24(5):425-31. doi: 10.1097/ICU.0b013e3283645b41.

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