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1.
早产儿视网膜病变发病情况分析   总被引:4,自引:0,他引:4  
目的 分析早产儿视网膜病变(ROP)的发病情况.方法 回顾性分析2005年9月至2008年5月来就诊的胎龄小于36周、体重低于2500g的210例早产儿的眼底筛查情况及高危因素.结果 210例早产儿中,ROP的发生率为12.9%,其中ROP3期以上的发生率为3.8%;低孕周、低体重、出生后吸氧时间过长、严重的新生儿疾病的早产儿ROP发生率高;双生子ROP发生率(20.5%)高于单生子(10.8%),且ROP发生严重.结论 低孕周、低体重、出生后吸氧时间过长、患严重的新生儿疾病、非单生子等是引起早产儿视网膜病变的高危因素.  相似文献   

2.
严重早产儿视网膜病变危险因素分析   总被引:2,自引:0,他引:2  
目的分析严重早产儿视网膜病变(ROP)的危险因素,为合理制定ROP筛查标准提供参考依据。方法回顾性分析2002年12月至2004年4月期间我院眼科就诊的168例孕龄<37周的早产儿临床资料。记录其性别、胎数(BC)、孕龄(GA)、出生体重(BW)、氧疗时间以及双眼充分散瞳后双目间接检眼镜检查所见的视网膜血管发育情况。按ROP国际分类法(ICROP)记录检查结果,1、2、3期为轻度ROP,阈值病变、4期和5期为严重ROP。应用多元Logistic回归分析分析ROP与性别、BC、GA、BW、氧疗时间等因素之间的关系。结果168例早产儿336只眼中,严重ROP 47例91只眼,分别占患儿例数和眼数的28.0%、27.1%。其中,阈值病变20只眼,占6.0%;4期病变11只眼,占3.3%。4期病变中,4A期2只眼,占0.6%;4B期9只眼,占2.7%。5期60只眼,占17.8%。各因素中,GA、BW和氧疗时间对严重ROP的发生有影响(P值分别为0.000、0.000和0.015,α=0.05),性别和BC与ROP无关(P值分别为0.640和0.084,α=0.05)。亚变量统计分析显示,当GA≤30周或BW≤1500 或氧疗时间>4d时早产儿患严重ROP的危险性显著增加。结论严重ROP的发生受GA、BW和氧疗时间的影响,而与性别和BC无关。GA≤30周或BW≤1500g或氧疗时间>4d的早产儿患严重ROP的危险性显著增加,建议重点对此类早产儿进行筛查。(中华眼底病杂志,2005,21:271-274)  相似文献   

3.
目的探讨重症早产儿视网膜病变(ROP)的发生率及高危因素分析对临床筛查的指导意义。方法回顾性分析2013年1月至2015年12月756例早产儿临床资料,记录其孕周、出生体重、吸氧时间、吸氧浓度、APgar评分(1分钟in)、APgar评分(5 min)、败血症、呼吸暂停、机械通气、输血等。应用t检验、卡方检验以及Logistic回归分析分析重症ROP与孕周(GA)、出生体重(BW)、吸氧时间、吸氧浓度、APgar评分(1 min)、APgar评分(5 min)、败血症、呼吸暂停、机械通气、输血等因素之间的关系。结果 756例早产儿,严重ROP发生3.3%。各因素中,孕周较少、低出生体重、长时间吸氧、高浓度吸氧、APgar评分(5 min)<4分,机械通气、输血是重症ROP的高危因素,统计学有显著差异。结论严重ROP的发生受孕周较少、低出生体重、长时间吸氧、高浓度吸氧、APgar评分(5 min)<4分,机械通气、输血影响。特别是GA≤28周或BW≤1000 g早产儿患严重ROP的危险性显著增加,建议重点对此类早产儿进行及时筛查。  相似文献   

4.
早产儿视网膜病变的筛查及其相关因素分析   总被引:34,自引:1,他引:34  
Yin H  Li XX  Li HL  Zhang W 《中华眼科杂志》2005,41(4):295-299
目的 探讨发生早产儿视网膜病变(ROP)的全身高危因素。方法 对2002年7月1日至2003年6月30日在北京妇产医院出生的胎龄≤34周或体重≤2000g的早产儿进行眼部检查,并分析发生ROP的相关因素。结果 北京妇产医院98例早产儿中,有17例发生ROP,ROP发生率为17 .3%。出现阈值病变需进行激光治疗者4例(7只眼),占4. 1%。ROP组与正常眼底组早产儿在胎龄、出生体重、吸氧时间( >5d)和最高氧分压及发生败血症方面的差异均有统计学意义(均P<0. 05)。Logistic回归分析结果表明小胎龄、低出生体重等是发生ROP的基本因素,长时间吸氧是发生ROP的危险因素。结论 小胎龄、低出生体重、长时间吸氧等因素与ROP的发生有关。  相似文献   

5.
《Ophthalmic epidemiology》2013,20(3):166-170
Purpose: To determine the incidence and risk factors for the development of retinopathy of prematurity (ROP) among premature infants.

Methods: New born infants with gestational age < 37 weeks were studied from October 2004 to April 2008. Potential risk factors, like gestational age (GA), birth weight (BW), supplemental oxygen therapy, acute respiratory distress syndrome (ARDS), sepsis, blood transfusion, and phototherapy were assessed.

Results: One hundred seventy-three newborn infants were evaluated. Mean BW ± standard deviation (SD) was 1680.64?±?462.5?g and Mean GA ± SD was 32.24?±?2.36 weeks. Incidence of ROP was 19% including 11.5% in prethreshold and 7.5% in threshold stages.

The incidence of ROP was 47.3% for infants with gestational age ≤ 32 weeks. All 33 infants with ROP had a gestational age of ≤ 34 weeks. The incidence of ROP was 33.3% for infants with BW < 1500 gr. ROP developed in 2 (6%) infants with BW > 2000 gr. Blood transfusion (Odds Ratio [OR]?=?2.45, P?=?0.031), phototherapy (OR?=?2.405, P?=?0.038), gestational age (OR?=?14.2, P?=?0001) and ARDS (OR?=?2.1, P?=?0.047) were associated to ROP. With multivariate logistic regression analysis, low GA and blood transfusion were related to ROP.

Conclusions: The results show that the incidence of ROP is relatively high in our region. Low GA, low BW, phototherapy, ARDS, and blood transfusion were the main risk factors for development of ROP.  相似文献   

6.
目的:分析8年间孕周<28周的超早产儿(EPI)早产儿视网膜病变(ROP)的发生情况及危险因素。方法:回顾性研究。2011年1月1日至2018年12月31日天津市中心妇产科医院新生儿重症监护病房收治的孕周<28周的EPI 300例纳入研究。记录EPI出生孕周(GA)、出生体重(BW)、性别等基本资料和新生儿呼吸窘迫综合...  相似文献   

7.
PURPOSE: The purpose of this study was to evaluate the incidence and severity of retinopathy of prematurity (ROP) in infants of birth weight less than 1.500 g and/or under 32 weeks'gestation. METHODS: Ninety-four preterm infants were examined following the Royal College of Ophthalmologists guidelines and retinopathy was graded using the International Classification of ROP. Screening limits were 1 500 g birth weight or 32 weeks'gestational age. Fundus examinations for ROP were performed at 5 weeks'chronological age from birth. Pupil dilation was obtained with instillation of 1% tropicamide three times at 15-minute intervals. RESULTS: The 94 infants examined for ROP had a median gestational age of 292.3 weeks and a median birth weight of 1 110340 g. ROP was diagnosed in 21 of 94 subjects (22.3%) by fundus examination. ROP stage 3 developed in one preterm infant, ROP stage 2 developed in five preterm infants, and ROP stage 1 developed in 15 preterm infants. No premature babies developed stage 4 or stage 5 ROP. The disease regressed spontaneously in all cases and none of the infants required cryo/laser therapy. In the most premature infants, 23-26 weeks'gestation, 57% developed ROP and one developed severe ROP (stage 3). No disease more posterior to peripheral zone 2 was observed. The incidence of ROP was higher in infants exposed to greater than 21% oxygen (24.2%) than in infants who did not receive oxygen (17.8%). Oxygen, blood transfusion, and cardiopathy appear to be associated with an increased incidence of retinopathy of prematurity. CONCLUSIONS: ROP continues to be a common problem associated with prematurity in France. This study found a similar incidence of prethreshold ROP when compared to recent studies. The data showed that blood transfusion and cardiopathy may play a role in the development of ROP in premature infants.  相似文献   

8.
目的:分析处于严重活动期的早产儿视网膜病变(ROP)患儿氧疗情况和所患疾病的相关性。方法: 病例对照研究。收集2017年11月至2019年10月在青岛市妇女儿童医院新生儿医学中心出生的早产 儿,在生后4~6周或矫正胎龄32周开始对其进行眼底检查以及氧疗情况的记录,根据是否发病以及 发病的严重程度分为轻症组和重症组。2组间发病情况比较采用χ2 检验,组间计量资料的比较采用 t检验或Mann-Whitne U检验。结果:共纳入符合研究条件的早产儿464例,其中眼底正常或轻度活 动期ROP的轻症组426例(91.8%),严重活动期ROP的重症组38例(8.2%)。在337例接受氧疗的早产 儿中,重症组的氧疗时间明显长于轻症组,差异有统计学意义(Z=-7.074,P<0.001);吸氧浓度的比 较,2组差异无统计学意义;将吸氧方式按照单种与多种方式进行比较,2组差异无统计学意义,但是 重症组机械通气的使用更为频繁,差异有统计学意义(Z=4.114,P=0.043)。对所有早产儿所患疾病 进行分析,发现重症组发生新生儿呼吸窘迫综合征(NRDS)、新生儿支气管肺发育不良(NBPD)的 概率更多,差异有统计学意义(χ2 =14.515,P<0.001;χ2 =4.601,P=0.032)。多因素回归分析发现,氧 疗时间是影响严重活动期ROP的独立危险因素(χ2 =18.127,P<0.001)。结论:更长时间的氧疗和机械 通气的频繁使用增加了严重活动期ROP的发生。新生儿窒息、NRDS、NBPD在严重ROP患儿中更 多见。氧疗时间、给氧方式以及吸氧浓度是发生严重的活动期ROP的危险因素。  相似文献   

9.
目的 了解早产儿视网膜病变(retinopathy of prematurity,ROP)发病情况.方法 回顾性分析2009年6月至2010年10月间在东莞市人民医院ROP发病率及其特点.结果 接受筛查的早产儿共126例,发生ROP病变的21例,均为双眼发病,发病率16.67%,未到阈值前病变的19例,发病率15.08...  相似文献   

10.
Objective: To analyze the oxygen therapy and neonatal-related diseases in severe, active retinopathy of prematurity (ROP). Methods: This was a case control study. Preterm infants born in the neonatal medical center of Qingdao Women and Children's Hospital from November 2017 to October 2019 were enrolled, and their fundus examination and oxygen therapy were recorded at 4-6 weeks after birth or 32 weeks of corrected gestational age. Patients were divided into a mild group and severe group based on the severity of the disease. A χ2 test was used to compare the incidence between the two groups, and a t test or MannWhitney U test was used to compare the measurement data between the two groups. Results: A total of 464 preterm infants were included in the study; 426 infants (91.8%) were in the mild group with normalor mildly active ROP, and 38 infants (8.2%) were in the severe group with severely active ROP. In the 337 premature infants receiving oxygen therapy, the duration of oxygen therapy in the severe group was significantly longer than that in mild group (Z=-7.074, P<0.001). There was no significant difference in oxygen concentration or oxygen inhalation mode between the two groups. However, the use of mechanical ventilation was more frequent in the severe group (Z=4.114, P=0.043). By analyzing the diseases of all premature infants, we found that the incidence of neonatal respiratory distress syndrome (NRDS), and neonatal bronchopulmonary dysplasia (NBPD) was higher in the severe group (χ2 =14.515, P<0.001; χ2 =4.601, P<0.032). Multivariate regression analysis showed that the duration of oxygen therapy was an independent risk factor (χ2 =18.127, P<0.001). Conclusions: A longer duration of oxygen therapy and frequent use of mechanical ventilation increased the incidence of severe, active ROP. Neonatal asphyxia, NRDS and NBPD were more common in severe ROP. The duration of oxygen therapy, oxygen supply mode and oxygen concentration were the risk factors for serious, active ROP.  相似文献   

11.
AIM: To compare refraction and keratometry readings between premature and term babies at 40 weeks' postconceptional age (PCA), and the possible effect of birth weight (BW) and gestational age (GA) on ocular parameters. METHODS: 33 preterm babies hospitalised in the neonatal unit between January and March 2002 were matched with 33 term babies born within the same period and hospitalised in the same unit. The preterm group underwent funduscopy at 4-5 weeks after delivery. Ophthalmic examination at 40 weeks' PCA included cycloplegic retinoscopy, funduscopy, and keratometric measurements. Mean and standard deviation of refraction, astigmatic power (plus cylinder), axis of astigmatism, and keratometric reading were calculated and compared between groups and correlated with BW and GA in the premature babies. RESULTS: Retinopathy of prematurity (ROP) stage 1 or 2 was noted in 88% of the premature babies on the first funduscopy examination, but only in 36% by the corrected age of 40 weeks. Statistically significant between groups differences were found for cycloplegic refraction (p = 0.02 for both eyes) and keratometry (p = 0.001 for both eyes). GA and BW had no impact on the refractive and keratometric findings in the preterm babies. CONCLUSIONS: Babies with mild ROP at the corrected age of 40 weeks have mild hypermetropia compared to the moderate hypermetropia found in term babies (a difference of 50%), and they have higher and steeper keratometric values. The greater corneal curvature may contribute to the development of myopia. Ophthalmologists and parents need to be aware of the possibility of visual dysfunction already very early in life even in relatively older premature infants.  相似文献   

12.
PURPOSE: To analyse the trends over 16 years (1982-97) in a Danish county regarding the clinical appearance of retinopathy of prematurity (ROP). METHODS: The data for birth years 1993-97 regarding the regular ophthalmic surveillance for ROP in the region have been analysed. With gestational age (GA) 32 weeks and/or a birthweight (BW) 1750 g as attempted screening limits a total of 177 premature infants were surveyed. Comparison was made with studies of a similar set-up from the preceding four 3-year periods comprising a total of 814 subjects. RESULTS: The number of survivors regarded at a higher risk of developing ROP (GA and BW both <32 weeks/1750 g, n=478) showed an even increase over the five investigation periods. The ROP frequency, however, fell from a level of 39% to 10%, there were fewer with severe sequels to ROP, and the children surveyed 'above limits' eventually avoided ROP. CONCLUSIONS: Using the ROP profile as a yardstick for the quality of the neonatal service given to the most immature newborns over the period 1982-97, the risk limits regarding GA and BW have gone down. More and more of the heavier preterm babies now escape ROP. A significant decrease in frequency of ROP in the more immature groups has been observed, and fewer cases have progressed to visual impairment.  相似文献   

13.
目的了解我院早产儿视网膜病变(retinopathy of prematurity,ROP)的发病状况,并对其相关危险因素进行分析探讨。方法对2007年1月至2008年11月在我院出生的124例(248只眼)早产儿(出生体重≤2500g或胎龄≤35周)进行ROP的筛查。所有患儿瞳孔散大后,通过巩膜外顶压详细检查患儿视网膜情况。按照ROP国际分类法的规定记录检查结果。将患儿全身状况及吸氧、母孕期吸氧、先兆子痫、胎盘早剥等因素进行统计。结果 124例患儿全部完成了眼底筛查,在周边视网膜血管化或病变退化后终止随访。9例(13只眼)出现ROP,发生率分别占患儿例数和眼数的7.26%和5.24%。其中6例(8只眼)ROP患儿未达到阈值前病变,3例(5只眼)为阈值前Ⅰ型病变,此3例ROP患儿给予间接检眼镜视网膜激光光凝术。所有激光治疗患儿术后随访观察,直至膜病变静止、消退,均未出现视网膜脱离。母孕期吸氧、先兆子痫、胎盘早剥等因素与ROP发病无关。结论低体重是ROP发生的最重要因素。对早产儿适时进行ROP筛查,并对发现的ROP早期进行有效视网膜激光光凝术,可控制病变,降低早产儿的致盲率。  相似文献   

14.
《Ophthalmic epidemiology》2013,20(6):269-274
Purpose: We aimed to determine applicable guidelines for screening of retinopathy of prematurity (ROP), and evaluate the contribution of risk factors for severe ROP.

Methods: A prospective cohort study of neonates with a gestational age (GA) < 34 weeks or birth weight < 2000g who were admitted to the Neonatal Intensive Care Unit (NICU) of a tertiary level hospital was conducted. The study group was classified into three groups according to eye examination findings as no ROP, mild ROP and severe ROP.

Results: Of the 700 neonates screened, the frequencies of ROP for any stage and severe ROP were 32.7% and 3.1%, respectively. Laser photocoagulation was needed in 9.6% of neonates with ROP. None of the neonates with a GA ≥ 31 weeks required treatment. Any ROP was detected in 199 (53.6%) of the babies < 32 weeks (n?=?371), 22 (5.9%) of whom were treated with laser photocoagulation. Independent risk factors for severe ROP in babies < 32 weeks GA were birth weight, duration of mechanical ventilation and patent ductus arteriosus (PDA).

Conclusion: This is the largest prospective cohort study including infants younger than 34 weeks GA from Turkey. Our data which belongs to the last 1-year period shows lower incidence of severe ROP when compared to previous reports from Turkey. According to our data, screening babies smaller than 32 weeks GA or 1500g birth weight seems reasonable. In the presence of long duration of mechanical ventilation and PDA, screening should be intensified.  相似文献   

15.
Background: To report the incidence of retinopathy of prematurity (ROP) in a subgroup of extremely premature infants admitted to an Australian tertiary centre over an 18‐year period. Design: Retrospective study. Royal Brisbane and Women's Hospital Neonatal Intensive Care Unit. Participants: Five hundred and fifty‐four infants admitted between 23 and 25.6 weeks gestational age (GA). Methods: The 18‐year study was divided into three 6‐year periods for analysis: period 1 (1992–1997), period 2 (1998–2003) and period 3 (2004–2009). Infants were compared based on their week of GA and by the study period in which they were born. Main Outcome Measures: GA, birthweight, incidence and severity of ROP. Results: Three hundred seventy‐three (67.3%) infants survived until ROP screening, and 351 (63.4%) survived until discharge. ROP incidence increased from 78.2% in period 1 to 86.1% in period 3. Over the entire study, 90.5% of 23‐week GA infants had ROP compared with 89.7% of 24‐week GA infants and 76.1% of 25‐week GA infants. Mean birthweight was significantly lower in infants with any ROP (725.1 g) and ROP of at least stage 3 (720.8 g) compared with infants without ROP (806.5 g) (P < 0.0001). Twenty‐three–week GA infants had more severe ROP (28.6%) than 24 weeks (18.3%) and 25 weeks GA (11.9%). Conclusions: There has been increased survival and incidence of ROP in extremely premature infants over the past 20 years. Lower birthweight and GA are both associated with higher incidence and more severe ROP.  相似文献   

16.
17.
李之喆  强丽莉  王珍 《国际眼科杂志》2012,12(11):2206-2207
目的:探讨苏州地区早产儿视网膜病变(retinopathy of prematurity,ROP)的发病情况以及与吸氧的相关性。方法:选择2011-05/2012-05在苏州及其周边地区符合ROP筛查标准的早产儿234例,出生体质量650~2550g,孕周27+4~36wk,并将其分为吸氧组与未吸氧组。运用卡方检验对数据进行统计学分析。结果:吸氧和未吸氧对ROP发病率的影响无显著性差异。结论:检验结果表明在氧浓度控制后,吸氧与未吸氧对ROP的影响无显著差异。说明吸氧并非ROP发生的直接原因,限定了氧的使用并不能完全阻止ROP的出现。  相似文献   

18.
Objective: To evaluate perinatal risk factors for retinopathy of prematurity (ROP), in a large, broad-risk cohort of premature infants.

Study design: Secondary analysis of data from the Postnatal Growth and ROP (G-ROP) Study, a retrospective cohort study of infants undergoing ROP examinations at 29 North American hospitals in 2006–2012.

Results: Among 7483 infants, 3224 (43.1%) had any ROP and 931 (12.4%) had severe ROP (Type 1 or 2 ROP). In multivariable logistic regression analysis, significant risk factors for any ROP were lower birth weight (BW, odds ratio (OR) = 5.2, <501 g vs. >1250 g), younger gestational age (GA, OR = 32, <25 vs. >29 weeks), 1-min Apgar score <4 (OR = 1.2), race (OR = 1.6, White vs. Black), outborn (OR = 1.5), and delivery room intubation (OR = 1.3); and for severe ROP were lower BW (OR = 20, <501 g vs. >1250 g), younger GA (OR = 30, <25 vs. >29 weeks), male (OR = 1.5), Hispanic ethnicity (OR = 1.8), race (OR = 1.6, White vs. Black), outborn (OR = 1.6), and delivery room intubation (OR = 1.6). Together, these factors predicted well for any ROP (area under ROC curve (AUC) = 0.87) and severe ROP (AUC = 0.89), but BW and GA were the dominant factors for ROP (AUC = 0.86) and severe ROP (AUC = 0.88).

Conclusions: Based on the largest report to date with detailed ROP data from infants meeting current screening guidelines, ROP risk is predominantly determined by the degree of prematurity at birth, with other perinatal factors contributing minimally.  相似文献   

19.
PURPOSE: The aim of this study was to analyse the results of retinopathy of prematurity (ROP) screening, stage of disease and time of treatment from one tertiary care centre. PATIENTS AND METHODS: Between 1991 and 2001, 666 infants with a gestational age (GA) < 33 weeks or birth weight (BW) less than < 1501 g were examined. Coagulation treatment was performed in accordance with the Cryo-ROP study, after reaching the threshold. All infants were followed-up until a stable retinal situation was reached. RESULTS: Mean GA of the 666 infants was 28.5 +/- 2.3 weeks. Mean BW was 1180 +/- 372 g. During the years of screening, the GA and BW significantly decreased, but no significant change in the yearly incidence of ROP was detected. 460 (69.1 %) of the infants did not develop any stage of ROP. Maximum stage of ROP in the worse eye was stage one in 51 (7.6 %) infants, stage two in 59 (8.9 %) infants and stage three below threshold in 62 (9.3 %) infants. 34 (5.1 %) infants were treated with coagulation treatment. Mean time of treatment was 36.5 weeks postmenstrual age, or 10.7 weeks postnatal age. Postnatal age showed a better correlation to treatment time than postmenstrual age. No infant was treated before seven weeks of life and not before 32 weeks postmenstrual age. CONCLUSION: In spite of the increasing survival of children with lower GA and BW the incidence of ROP has not increased, and the incidence of ROP in our centre appears to be comparable to other international studies. In contrast to the Cryo-ROP study, treatment time correlates better to postnatal age than to postmenstrual age. All infants who underwent treatment were detected at an appropriate time using German screening guidelines.  相似文献   

20.
ObjectiveThe aim of this study was to evaluate the incidence, severity, and treatment modalities of retinopathy of prematurity (ROP) in moderate and late preterm infants with a gestational age (GA) >31 + 6 weeks.MethodsROP screening results of preterm infants with GA >31 + 6 weeks to 36 + 6 weeks between March 2013 and January 2019 were evaluated retrospectively. Infants were divided into 2 groups according to GA as 32–33 + 6 weeks (moderate preterm) and 34–36 + 6 weeks (late preterm). In these groups, any ROP and severe ROP (requiring treatment) development rates and ROP types and treatment modalities were evaluated.ResultsA total of 4156 preterm infants, 1875 (45.1%) female and 2281 (54.9%) male, were included. Overall, 1466 (35.2%) of the infants were moderate preterm and 2690 (64.8%) were late preterm. The incidences of any ROP and severe ROP were 22% and 2.5%, respectively. The rate of severe ROP was 5.3% in moderate preterm infants and 0.9% in late preterm infants. Significant correlations were determined between duration of hospital stay, birth weight (BW), and GA with ROP development (r = +0.415, r = ?0.258, r = ?0.199, respectively; p < 0.001 for all). Of 102 patients (2.5%) requiring treatment, 64 (62.7%) had laser, 34 (33.3%) had intravitreal bevacizumab (IVB), 2 (1.9%) had sequential IVB and laser, and 2 (1.9%) had vitreoretinal surgery.ConclusionROP seems to still be an important health problem in moderate and late preterm infants in our country according to data from screening high-risk preterm infants with a GA >31 + 6 weeks. In this cohort, ROP development correlates with GA, BW, and duration of hospitalization significantly.  相似文献   

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