早产儿视网膜病变相关因素分析

目的研究早产儿视网膜病变的发病率，并分析其相关危险因素。方法对2007年9月～2010年8月新乡医学院第三附属医院新生儿科收治的体重〈2000g，胎龄〈34周的早产儿和低体重儿进行ROP筛查。于出生后2周始，由有经验的眼科医师进行间接检眼镜检查眼底，并记录完整的临床资料，调查ROP的发病率及分析相关危险因素。结果367例早产儿。ROP发病率为11．44％（42／367）。42例中ROPI期21例，Ⅱ期14例，Ⅲ期6例，Ⅳ期1例。激光手术9例（2．45％）。对367例早产儿相关因素分析提示，感染、贫血、窒息、吸氧时间〉7d、吸氧浓度〉40％、代谢性酸中毒、胎龄、呼吸暂停、输血与ROP的发生有相关性（P〈0．05）。Logistic回归分析提示，小胎龄、出生体重、吸氧时间〉7d、代谢性酸中毒、感染、输血、呼吸暂停是ROP发生的主要危险因素。结论防治早产儿的各种并发症的发生非常重要。感染、贫血、吸氧、酸中毒、窒息、胎龄与ROP相关；小胎龄、呼吸暂停、感染、输血、酸中毒是ROP发生的主要危险因素。

The relevant factors analysis of retinopathy of prematurity

Objective To study the incidence and relevantly risk factors of retinopathy of prematurity. Methods From September 2007 to August 2010, rop screening was carried out in premature infants and low birth weight infants （birth weight 〈 2000 g, gestational age 〈 34 weeks ） who were treated in neonatal department in the third hospital of Xinxiang medical unirersity, after 2 weeks, the infants＇fundus of eyes were examined by the salty ophthalmologist by indirect ophthalmoscope, complete clinical data were recorded, the inci- dence of ROP and relatively risk 367 factors were analyzed. Results The incidence of ROP with premature infants was 11.44 % （42/367）. Among 36 multiple premature infants with ROP, 21 patients were classified into stage I of ROP, 14 in stage II , 6 in stage ~, 1 in stage IV. The laser surgeries was operated on 9 patients（2.45% ）. The relevant factors analysis suggested infection, anaemia, asphyxia, the time of respiratory oxygen 〉 7 d, the concentration of inspired oxygen 〉 40%, metabolic acidosis, conceptus age, apnea, blood transfusion were associated with the occurrence of retinopathy of prematnrity （P 〈 0. 05 ）. Logistic regression analysis suggested coneeptus age, birth weight, the time of respiratory oxygen 〉 7 d, metabolic acidosis, infection, blood transfusion, apnea were main factors of the occurrence of retinopa- thy of prematurity. Conclusion The incidence of ROP is 11.44%. It is very important to prevention and cure all kinds of complication. Infection, anaemia, oxygen usage, acidosis, asphyxia, eonceptus age are associated with the occurrence of ROP. Conceptus age, apnea, infection, blood transfusion, acidosis are the main factors of the occurrence of ROP.