早产儿视网膜病107例临床特点及预后分析

摘要：目的　评价早产儿视网膜病（ROP）临床特点及远期治疗效果。方法　回顾性分析2004-01-01—2009-07-31复旦大学附属儿科医院新生儿科收治的107例ROP患儿临床资料、ROP分期、治疗情况及远期预后。结果　1期和2期ROP共64例，6例2期病变达Ⅰ型阈值前病变而采用激光治疗，其他均未进行特殊治疗；除失访和死亡病例外，所有随访病例ROP病变均消退，远期视力不受影响。3期病变15例，其中14例达阈值病变者给予激光或冷凝治疗，1例未达阈值病变者不需要治疗。有完整随访资料的11例患儿中3例术后视力严重受损，仅存在光感，其余8例视力正常。4期和5期ROP共28例，随访的18例患儿中，仅1例手术后保存了正常视力（占5.6％），失明者达12例（占66.7％），其余5例虽保存视力，但视力极差，仅存光感（占27.7％）。结论　ROP防治关键在于预防ROP发生，当出现ROP早期病变时应严格筛查和及时干预，一旦疾病进入晚期，出现视网膜脱离时再治疗，则治疗效果不佳。

Analysis of clinical features and prognosis of 107 cases of retinopathy of prematurity.

Abstract：Objective　To evaluate the clinical features of retinopathy of prematurity （ROP） and the long-term therapeutic effect. Methods　The clinical data ， ROP stage ， the therapy and long-term prognosis of 107 preterm infants with ROP were retrospectively analyzed，who were admitted to Children’s Hospital of Fudan University between January 1， 2004 to July 31， 2009. Results　Among 64 preterm infants with Stage 1 or 2 ROP， 6 infants with Stage 2 ROP developed to type I threshold ROP and received the laser therapy. All the follow-up infants except the death did not need special treatment without the vision affected later and the lesions of ROP were self-limiting. Fifteen infants were detected with Stage 3 ROP， of whom 14 infants had threshold ROP and received the laser therapy. Another one infant who did not develop to the threshold ROP had no treatment. Eleven follow-up infants had no blindness ， but three infants’ vision was affected severely after the treatment and 8 infants had the normal vision. There were 28 Stage 4 or 5 ROP infants，but 18 infants were followed up completely. In follow-up infants ， there was only one infant with the normal post-operative vision（5.6%）， 12 ones had blindness after treatment （66.7%）， and the remaining five ones had poor eyesight and  were light-sensitive （27.7%）. Conclusion　It’s a key step to screening and intervention in time at the early stage of ROP. Otherwise the outcome is very poor when developed to the late stage with retinal detachment.