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早产儿视网膜病变的筛查和新疗法 - 综述。

Screening and novel therapies for retinopathy of prematurity - A review.

机构信息

Department of Ophthalmology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Department of Ophthalmology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

出版信息

Early Hum Dev. 2019 Nov;138:104846. doi: 10.1016/j.earlhumdev.2019.104846. Epub 2019 Aug 29.

Abstract

With current screening for sight threatening retinopathy of prematurity (ROP) <10% of screened infants need treatment. Prediction models based on birth characteristics, postnatal weight gain and other factors have been developed to reduce examinations in low-risk infants. A model based on advanced statistics using data from >7000 infants registered in the Swedish ROP registry is being developed. Based on birth characteristics only, it appears to predict total risk of ROP-treatment as well as models including weight measurements. Treatment risk peaked at 12 weeks of age. Laser therapy is the method of choice for severe ROP. Anti-VEGF therapies are implemented worldwide despite insufficient knowledge of choice of drug, dosage and long term systemic effects. Prevention of ROP may be achieved through oxygen control and provision of the mother's breastmilk. Other interventions such as supplementation with long chain polyunsaturated fatty acids and preservation of fetal haemoglobin are investigated.

摘要

目前,对早产儿视网膜病变(ROP)的筛查率<10%,需要治疗的婴儿数量较少。已经开发了基于出生特征、出生后体重增加和其他因素的预测模型,以减少低危婴儿的检查次数。正在使用瑞典 ROP 登记处登记的>7000 名婴儿的数据,基于高级统计学开发了一种模型。仅基于出生特征,它似乎可以预测 ROP 治疗的总风险,以及包括体重测量的模型。治疗风险在 12 周龄时达到峰值。激光治疗是严重 ROP 的首选方法。尽管对药物选择、剂量和长期全身影响了解不足,但抗 VEGF 治疗已在全球范围内实施。通过控制氧气和提供母亲的母乳可以预防 ROP。正在研究其他干预措施,如补充长链多不饱和脂肪酸和保存胎儿血红蛋白。

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