早产儿视网膜病变筛查及相关因素分析

目的：分析我院早产儿视网膜病变( retinopathy of prematurity，ROP)的发病情况，探讨其相关因素。方法回顾性分析2013年9月至2014年9月我院新生儿科住院的182例早产儿(出生体重<2000 g或胎龄<37周)的临床资料。于生后第4~6周或纠正胎龄32周进行ROP筛查，并定期随访。结果182例早产儿中筛查出不同程度ROP患儿32例，占17.6％，其中单眼10例，双眼22例。ROP患儿平均出生胎龄为(29.3±1.5)周，平均出生体重为(1280±240)g，其中ROP 1期11例，2期5例，3期16例，附加病变5例，住院期间18例患儿行视网膜激光光凝手术，2例行Lucentis球内注射。ROP组患儿与非ROP组在出生体重、胎龄、吸氧、肺表面活性物质应用、感染、窒息、输血方面比较，差异有统计学意义(P<0.05)。 Logistic回归分析显示胎龄、吸氧、机械通气、肺表面活性物质应用对ROP的发生有明显影响( P<0.05)。结论胎龄、出生体重、吸氧、呼吸暂停、感染等因素与ROP的发生有关，出生体重及胎龄越低，ROP发病率越高。

Screening of retinopathy of prematurity and risk factor analysis

Objective To investigate the present incidence and the risk factors of retinopathy of pre-maturity( ROP) . Methods The clinical data of 182 premature infants who were born in our hospital from Sep 2013 to Sep 2014 with birth weight <2 000 g and gestational age<37 weeks were analyzed retrospec-tively,and were divided into ROP group and without ROP group. They were screened for ROP from 4 to 6 weeks of chronological age or 32 weeks of postmenstrual age. Results In 182 cases, there were 32 cases with ROP,the incident rate was 17. 6%. Among them,10 cases were monocular and 22 cases were binocular with ROP. In ROP groups,the mean gestational age was(29. 3 ± 1. 5) weeks and the birth weight was(1 280 ± 240)g. Eleven cases developed to stage 1 of ROP,5 cases developed to stage 2 of ROP,16 cases developed to stage 3 of ROP and 5 cases with plus lesions. Eighteen cases were treated by laser photocoagulation and 2 cases received intravitreal ranibizumab injections. Compared with the infants without ROP,the development of ROP was correlated with birth weight,gestational age,oxygen supplement,use of pulmonary surfactants,in-fection,apnea,and blood transfusions(P<0. 05). Logistic regression analysis suggested that gestational age, oxygen inhalation,use of pulmonary surfactant,and mechanical ventilation were significant risk factors associ-ated with the development of ROP(P<0. 05). Conclusion The factors associated with ROP are gestational age,birth weight,oxygen inhalation,apnea and infection. The lower of the birth weight and gestational age, the incidence of ROP is higher.