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早产儿视网膜病变的氧疗和治疗对眼部和神经预后的影响。

Oxygen care and treatment of retinopathy of prematurity in ocular and neurological prognosis.

机构信息

Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Republic of Korea.

Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea.

出版信息

Sci Rep. 2022 Jan 10;12(1):341. doi: 10.1038/s41598-021-04221-8.

Abstract

This retrospective cohort study aimed to investigate the effects of neonatal oxygen care and retinopathy of prematurity (ROP) treatment on ROP-related ocular and neurological prognoses. We included premature infants treated for ROP at a tertiary referral center between January 2006 and December 2019. Demographic and clinical data were collected from electronic medical records. Odds ratios (ORs) of oxygen care- and ROP treatment-related factors were calculated for ocular and neurological comorbidities 3 years after ROP treatment, after adjusting for potential confounders. ROP requiring treatment was detected in 171 eyes (88 infants). Laser treatment for ROP (OR = 4.73, 95% confidence interval [CI] 1.64-13.63) and duration of invasive ventilation (OR = 1.02, 95% CI 1.00-1.03) were associated with an increase in ocular comorbidities, along with a history of neonatal seizure (OR = 28.29, 95% CI 5.80-137.95) and chorioamnionitis (OR = 32.13, 95% CI 5.47-188.74). No oxygen care- or ROP treatment-related factors showed significant odds for neurological comorbidities. Shorter duration of invasive oxygen supply during neonatal care (less than 49 days) and anti-vascular endothelial growth factor injection as the primary treatment for ROP are less likely to cause ocular comorbidities. No association was identified between ROP treatment modalities and the risk of neurological comorbidities.

摘要

这项回顾性队列研究旨在探讨新生儿氧疗和早产儿视网膜病变(ROP)治疗对 ROP 相关眼部和神经预后的影响。我们纳入了 2006 年 1 月至 2019 年 12 月在一家三级转诊中心接受 ROP 治疗的早产儿。从电子病历中收集人口统计学和临床数据。在 ROP 治疗后 3 年,通过调整潜在混杂因素,计算氧疗和 ROP 治疗相关因素与眼部和神经合并症的比值比(OR)。ROP 治疗需要 171 只眼(88 例婴儿)。ROP 激光治疗(OR=4.73,95%置信区间[CI]1.64-13.63)和有创通气时间(OR=1.02,95%CI 1.00-1.03)与眼部合并症的增加相关,此外还与新生儿癫痫发作史(OR=28.29,95%CI 5.80-137.95)和绒毛膜羊膜炎史(OR=32.13,95%CI 5.47-188.74)相关。在神经合并症方面,没有发现与氧疗或 ROP 治疗相关的因素具有显著的优势。新生儿期接受有创氧疗时间较短(<49 天)和抗血管内皮生长因子注射作为 ROP 的主要治疗方法不太可能导致眼部合并症。ROP 治疗方式与神经合并症风险之间没有关联。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/11b8/8748614/86b68ea530ca/41598_2021_4221_Fig1_HTML.jpg

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