早产儿视网膜病变高危致病因素分析

目的 探讨早产儿视网膜病变(ROP)发生的高危致病因素.方法 对2005年1月1日至2008年6月30日在深圳市儿童医院、深圳市妇幼保健院及深圳市眼科医院就诊的胎龄≤34周或出生体重≤2000 g的早产儿进行眼底检查,并对ROP高危致病因素进行多因素分析.结果 完成筛查的219例早产儿中,21例(42只眼)发生ROP,占9.6%,其中阈值病变6例(12只眼),占2.7%.单因素分析显示,ROP的发生与出生体重、孕周、首次救治医院有无新生儿重症监护(NICU)、吸氧＞5d、窒息以及贫血等6项高危因素有关.结论 ROP的发生与孕周短、出生体重低和吸氧时间长有关.     

重症早产儿视网膜病变的高危因素分析

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。     

早产儿视网膜病变筛查结果分析

目的 探索适合成都及周边地区早产儿视网膜病变(retinopathy of prematurity,ROP)的筛查模式.方法 回顾性调查分析研究.对2007年12月至2011年3月在四川省人民医院及成都市妇女儿童中心出生的332例体重2500g以下或孕周小于34周的早产儿,自生后4～6周或矫正胎龄32周开始筛查至周边视网膜血管化.结果 332例早产儿中有41例发生了早产儿视网膜病变,占12.35％.其中严重的4例(7只眼)接受了激光治疗,1例(1只眼)接受视网膜冷凝联合巩膜环扎手术治疗,占1.20％.按照卫生部制定的筛查标准,仅259例受检儿符合标准,ROP检出率为14.29％,有4例ROP患儿漏诊.眼底正常组患儿出生孕周和体重均明显高于ROP组,两组间有吸氧史者所占比例及不同严重程度ROP组与未发生ROP组吸氧时间的差异有统计学意义.结论 出生体重、胎龄、吸氧为早产儿视网膜病变发生的重要危险因素,婴儿出生的成熟度越低,早产儿视网膜病变尤其是严重的早产儿视 网膜病变发病可能性越高.成都及周边地区ROP筛查标准应在卫生部制定的ROP筛查标准的基础上适当扩大范围.     

双胞胎早产儿视网膜病变发生率及其相关因素分析

目的探讨并分析双胞胎早产儿视网膜痛变（retinopathy of prematurity，ROP）的相关因素。方法对2003年12月至2004年8月在本院就诊的30对双胞胎早产儿（60眼）从出生后4周开始做眼部检查。记录出生体重、性别、给氧、伴随疾病（新生儿窒息、肺透明膜病、心室内出血、动脉导管未闭）等对资料完整的患儿做相关性分析。结果在30对双胞胎早产儿中较低体重早产儿ROP的发生率为25％．较高体重早产儿的发生率为18．3％；Logistic回归分析表明双胞胎早产儿ROP发病率与给氧具有相关性（P〈0．05）；双胞胎中高体重与低体重患儿的ROP发生率差异无显著性（P〉0．05）。双胞胎中有并发症的高体重与低体重患儿的ROP发生率差异无显著性（P〉0．05）。双胞胎中无并发症的高体重与低体重患儿的早产儿视网膜病变发生率差异无显著性（P〉0．05），双胞胎中有吸氧史的高体重与低体重患儿的早产儿视网膜病变发生率差异无显著性（P〉0．05），双胞胎中无吸氧史的高体重与低体重患儿的早产儿视网膜病变发生率差异无显著性（P〉0．05）。结论①双胞胎早产儿视网膜病变发生率与其是否是双胞胎无关,与有无并发症无关，而与其是早产儿有关。②吸氧是双胞胎早产儿视网膜病变的危险因素。     

早产儿视网膜病变的临床分析

目的 观察早产儿视网膜病变发生发展及危险因素,探讨其合理的筛查标准和治疗模式.方法 对胎龄≤35周,体重≤2500g患儿进行ROP筛查,并行危险因素相关性分析.结果 共筛查326例符合条件的早产儿,发现早产儿视网膜病变患儿33例(10.12%);3期及以上组,1～2期组及未发生病变组的吸氧时间有显著性差异(P<0.05);出生体重≤1000g组,1001～1500g组,1501～2000g组,2001～2500g组患病百分比有显著性差异(P<0.05);出生胎龄≤30周组,30周<出生胎龄≤32周组,32周<出生胎龄≤35周组间ROP患病百分比有显著性差异(P<0.05);单生子与多生子患病率有显著性差异(P<0.05);少数全身病情严重者可在32周前发生ROP;病变严重程度与性别无关,与孕龄、出生体重、氧疗时间、胎数等因素有显著相关.9例患儿行冷凝术,手术效果满意.结论 吸氧时间长、体重低于1500g、胎龄小于32周多生子中发病率高,对一些高危产儿应尽早行ROP筛查;病变严重程度与性别无关,与孕龄、出生体重、氧疗时间、胎数等因素有显著相关,及早行冷冻术病情控制满意.     

早产儿视网膜病变的筛查及其相关因素分析

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。     

早产儿视网膜病变发病情况分析

目的回顾性分析2004年7月至12月我院早产儿视网膜病变(ROP)的发病情况。方法对2004年7月至12月出生的89例体重2000g以下或孕周小于34周的早产儿,自生后4~6周或矫正胎龄32周开始筛查至周边视网膜血管化。结果89例早产儿有9例发生了早产儿视网膜病变,占10.11%,其中严重的3例接受了激光治疗,占3.37%。结论出生体重、胎龄为早产儿视网膜病变发生的重要危险因素,婴儿出生的成熟度越低,早产儿视网膜病变尤其是严重的早产儿视网膜病变发病可能性越高。     

早产儿视网膜病变筛查结果分析

目的 了解早产儿视网膜病变(ROP)的发病情况,并探讨相关危险因素.方法 对符合ROP筛查标准的早产儿201例(402只眼),用间接眼底镜进行眼底筛查,记录眼底检查情况.结果 出生孕周27～ 36周,出生体重750～ 2500g早产儿201例,正压给氧48人次,持续1～17d.鼻导管吸氧53人次,持续1～55d,无1例出现ROP.结论 严格控制吸氧可以控制ROP的发病.     

早产儿视网膜病变的筛查与高危因素分析

目的 研究早产儿视网膜病变(ROP)发病情况及相关的危险因素,探讨其合理的筛查标准.方法 对出生体重≤2500g,胎龄≤37周患儿进行ROP筛查,并行相关因素分析.结果 共筛查275例符合条件的早产儿,发现ROP38例(13.82%);出生体重≤1500g组,～2000g组,～2500g组患病百分比有显著性差异(P<0.05);出生胎龄≤30周组,～32周组,≥33周组间ROP患病百分比有显著性差异(P<0.05);ROP早产儿的吸氧时间明显高于无ROP组(Z=5.292,P=0.000),需要机械辅助呼吸的早产儿发生ROP者较多(x2=30.597,P=0.000),多胎与单胎间发生ROP的差异无统计学意义(x2=0.748,P=0.387),ROP发病与出生胎龄、出生体重、吸氧时间、机械辅助呼口等因素相关.结论 出生体重越低,出生胎龄越小,吸氧时间较长,需要机械辅助呼吸的早产儿,ROP患病率越高.早产儿应及时检查眼底,尽早发现ROP.     

汕头市早产儿视网膜病变筛查结果分析

目的：了解汕头地区早产儿视网膜病变( retinopathy of prematurity, ROP)发病情况,探讨适合汕头地区的 ROP筛查标准。
　　方法：对2011-01/2014-12在汕头4家医院NICU住院的1813例出生体重≤2000 g的低出生体重儿或胎龄≤34周的早产儿采用双目间接眼底镜和(或)广角数码儿童成像系统( RetCamⅡ)进行ROP筛查,所有患儿随访至视网膜完全血管化或病变退化。
　　结果：发现ROP 202例388眼,占筛查总例数11.14%。其中重症ROP(阈值前期Ⅰ型或阈值期)43例85眼,占筛查总例数2.37%。出生体重<1500 g新生儿408例,重症ROP 34例67眼,占全部重症 ROP 病例的79.07%。GEE模型分析结果表明,低出生体重、小胎龄及吸氧是ROP的高危因素。
　　结论：汕头地区ROP检出率11.14%,但重症ROP检出率较低,主要发生于出生体重<1500 g低出生体重儿和出生胎龄≤34周的早产儿。低出生体重、小胎龄及吸氧是ROP的高危因素。     

Analysis of risk factors for retinopathy of prematurity

AIM: To analyze the incidence and risk factors for retinopathy of prematurity (ROP). METHODS: A retrospective analysis was conducted on 568 premature infants from September 2005 to December 2010 with birth weight(BW) equal to or less than 2 500g or a gestational age(GA) at birth of 34 weeks or less. All of the members were examined by indirect binocular ophthalmoscopy. RESULTS: ROP occurred with an incidence rate of 10.7% among 568 premature infants, and stages 3 and above ROP occurred with an incidence rate of 2.5%. This study showed the infants were more prone to develop ROP with short geststional age, low BW, long time of oxygen inhalation, and severe infants diseases. Twins had a significantly higher rate of ROP(18.3%) than singleton babies(9.8%), ROP were severer in twins than singleton babies . CONCLUSION: Short GA, low BW, long time of oxygen inhalation, severe infants diseases, and non-singleton babies were the most significant risk factors associated with ROP.     

Retinopathy of prematurity in a tertiary center in south of Brazil

AIM: To investigate the incidence of retinopathy of prematurity(ROP) in the southern Brazil, the rate of treatment and outcomes in all premature infants born at Hospital de Clinicas de Porto Alegre, Brazil, from October 2002 to October 2006. · METHODS: A prospective cohort study was conducted on 323 premature children born at Hospital de Clinicas de Porto Alegre, Brazil, from October 2002 to October 2006 with birth weight equal to or less than 1 500g or a gestational age at birth of 32 weeks or less. All of the newborns were examined by indirect binocular ophthalmoscopy with the 28 diopters lens after pupil's dilation and a lid speculum after the sixth week of life with examinations repeated depending on the disease classification. The main clinical outcome was the occurrence of ROP at any stage. · RESULTS: ROP occurred in 82 infants with an incidence rate of 25.7%. Threshold disease occurred in only 17 of the patients (5.3%), all of them had the disease affecting posterior Zone II needing laser treatment. None of the treated children had Zone I or aggressive posterior disease despite that three of the treated children needed a second laser session. One patient of the re-treated group needed scleral buckling with an equatorial silicon band after progression to stage 4 of ROP. · CONCLUSION: The incidence of retinopathy and the threshold disease in this study was similar to the international results reported. This study showed a high survival rate (70.1%), high incidence of retinopathy, and high laser treatment necessity among newborns under 28 weeks of gestational age or under 1 000g of birth weight. This study drove attention about the no identification of any Zone I posterior disease in this cohort of patients.     

Retinopathy of prematurity: evaluation of risk factors

Objectives: The purpose of this study was to determine what risk factors play a role in the development of retinopathy of prematurity (ROP). Study design: Data were collected on 157 infants born and cared for in one institution between January 1991 and July 1994. Initially we evaluated all children enrolled in the study to determine potential risk factors for the development of ROP. We subsequently compared multiple variables for ROP positive singletons with ROP positive twins to determine ROP risk factors for each group and to determine if one group was more susceptible to a given risk factor. Results: Of the 157 infants examined, 72 infants (46%) developed ROP. Infants who developed ROP had a lower gestational age, a lower birth weight, a higher number of days on oxygen/ventilator. more days in the intensive care unit (ICU), a greater need for steroids and a higher incidence of sepsis when compared to infants who did not develop ROP. There was no significant difference noted between singleton and twin gestation infants that developed ROP when comparing gestational age, weight, ventilator time or length of ICU stay. Total number of days on oxygen therapy was higher in the singleton group and this difference did reach statistical significance. Conclusions: Several risk factors are associated with a higher incidence of ROP. These variables may not be independent risk factors but may be a sign of the increased severity of illness associated with those infants who are born earlier with a lower birth weight. Multiple gestational births do not appear to increase the risk of developing ROP when compared to a similar group of singleton birth infants. This revised version was published online in July 2006 with corrections to the Cover Date.     

马来西亚一个三级保健医院早产儿视网膜病变的筛查

目的:本研究旨在确定马来西亚一个三级保健医院早产儿视网膜病变的发病率及发病趋势。方法:回顾分析在2003-2005年之间出生并进行ROP筛查的婴儿,记录每个患儿ROP的最严重分期。结果:我们对188名婴儿进行了筛查,平均出生体重1105.3±300.6g,平均妊娠期为29.2 ±2.6wk。这些婴儿整体的ROP发病率为29.18 % (55/188)。出生体重在750g及以下的婴儿发病率为76.2%。3a以来,低体重儿的数量及重型ROP病例数量呈现一个增长的趋势(P<0.05)。出生体重与婴儿受检数量之间存在负相关关系(P=0.000)。结论:随着低体重和小月分婴儿比例的增加,患ROP的患儿比例随之增加。     

巴西南部第三中心早产儿视网膜病变

目的:评估2002-10/2006-10在巴西de Clinicas de Porto Alegre医院出生的所有早产儿的早产儿视网膜病变(ROP)的发生率,其治疗和预后的比率.方法:对323例出生体质量低于或等于1 500 g或者出生时孕龄等于或者少于32wk的早产儿进行前瞻性队列研究.所有的新生儿都在出生后6wk内进行开睑器开睑,瞳孔散大,间接检眼镜及28D透镜眼底检查,根据疾病的分类进行复查.结果由均数表示,发病率为于95%的可信区间,主要的临床结果为任何分期的ROP发生.结果:新生儿82例发生了ROP,发生率为25.7%.患者中只有17例((5.3%)发生了阈病变,他们的病变都累及后部第Ⅱ区,需要激光治疗.除了3例经治疗的患儿需要两次激光治疗外,没有一个经过治疗的患儿有Ⅰ区病变或者严重的后部病变.重复治疗组的1例患儿因发展成为4期ROP而需要行赤道部硅胶带巩膜环扎术.结论:ROP的发生率和阈病变同国际其它的研究结果类似.本研究显示了孕期28wk以内或出生后体重1 000 g的新生儿高生存率(70.1%)、高视网膜病变发病率和激光治疗的高度必要性.这组患儿需要眼科专家和新生儿专家为发现ROP进行仔细筛查和随访.本组患儿中没有确诊1例有Ⅰ区后部病变,此点是本研究值得引起注意之处.     

Retinopathy of prematurity. Results of fundus examination performed in 94 preterm infants

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.     

Retinopathy of prematurity: are we screening too many babies?

PURPOSE: With advancement in neonatal care units, early detection of retinopathy of prematurity (ROP) in premature and very-low-birth-weight infants is important. Numerous studies have reported an increased risk of ROP in prematurely born infants, but only few have been long-term and strictly population-based. The aim of the present study was to find out whether birthweight <1251 grams and gestational age <30 weeks could provide a safe and efficient means of detecting treatable ROP. We have retrospectively tried to ascertain the incidence and associated risk factors that may contribute to the management of babies with ROP. METHODS: Infants either with a birth weight below 1500 g or a gestational age of less than 32 weeks were screened for ROP during an 8-year period by a single examiner.Results An incidence of 64/205 (31.2%) ROP was noted. The mean age at detection was 5.5 +/- 2 weeks of life. The maximum stage reached was stage 1 in 27 (13.2%), stage 2 in 24 (11.7%) and stage 3 in 10 (4.8%) babies. Threshold ROP was present in three (1.5%) babies. Significantly fewer (150/205 = 73%) babies would have been examined had a birth weight of <1251 grams and a gestational age <30 weeks been applied. there were five (8%) babies with birth weight >1250 grams and eight (12%) babies with gestational age >30 weeks amongst babies with ROP but all were stage 1 or stage 2. All the stage 3 ROP and the threshold ROP cases were babies with birth weight <1000 grams and gestational age below 28 weeks. CONCLUSION: Ophthalmic examination may be safely and efficiently concentrated in babies with birth weight <1251 grams and gestational age below 30 weeks. Birth weight (P < 0.005) and gestational age (P < 0.01) were the only significant risk factors. During this 8-year period there was no significant decrease in the number of babies screened for ROP and the overall incidence of all stages of the disease has remained constant. In the present series a lower incidence of severe ROP was noted compared to most previous studies. Our experience from this study suggests the need for further refinement of screening guidelines in order to focus screening on the vision-threatening stages of ROP.     

徐州地区早产儿视网膜病变相关因素分析

目的：了解徐州地区早产儿视网膜病变发病情况并分析相关影响因素。方法 ROP筛查患儿520例,收集整理相关资料并对其进行Logistic回归分析。结果完成筛查520例,检出74例（14.3%）,ROP的发生与母亲分娩年龄,婴儿性别,婴儿是否罹患HIE及母亲孕期吸氧史无关,胎龄和出生体重是保护因素,婴儿吸氧史,母亲孕期使用激素是危险因素。结论徐州地区ROP检出率14.3%,出生体重低,胎龄小,有吸氧史,及母亲孕期有激素使用史的早产儿ROP发病率较高。因此必须加强对此类患儿的ROP筛查。