早产儿视网膜病变筛查及危险因素的临床研究

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。

Evaluation on incidence of retinopathy of prematurity and its risk factors

Objective To investigate the incidence of retinopathy of prematurity（ROP） in our hospital and evaluate the correlation factors with the screening of prematurity.Methods Records of 124（248 eyes） premature infans who had undergo ROP（BW﹤2500g or GA﹤35W） screening between January 2007 to November 2008 were analyzed.We examined the peripheral retina with sclera depressor,Recorded the result according to the national critia of ROP.Analysis the correlation factors of every pore condition、oxygen inhalation、oxygen inhalation during pregnacy、preeclampsia、abruption.Results All of the premature infans had been accomplished ROP screening,stopping follow-up when peripheral retinal was completely vascularized.In them 9 cases（13 eyes） were fund ROP,the incidence of ROP in premature infans and total eyes was 7.26% and 5.24%.Of them 6 cases（8 eyes） were blow pre-threshold,3 cases（5 eyes） suffered from pre-threshold type 1 ROP,they were treated with retinal photocoagulation.The conclusion show the pathogeny of ROP had no related with oxygen inhalation during pregnacy、preeclampsia、abruption.Conclusion Low birth weight is the most important factor of ROP.The screening of ROP and effective therapy on time can control the development of disease and decrease the ratio of prematurity blind.