本院出生和外院转运早产儿视网膜病发病情况的对比研究

目的探讨广东省妇幼保健院出生和外院转运早产儿视网膜病(ROP)的发病及诊治情况。方法回顾性分析2013年1月至2015年12月收入广东省妇幼保健院新生儿重症监护室并诊断为ROP的755例早产儿的临床资料。本院出生组239例,外院转运组516例。收集2组患儿的胎龄、体质量、性别、ROP病变程度及手术治疗等资料。结果外院转运组ROP早产儿出生体质量[(1290.64±392.87)g]低于本院出生组[(1586.21±512.74)g],差异有统计学意义(P<0.001);外院转运组ROP早产儿诊断胎龄[(35.53±2.81)周]高于本院出生组[(34.51±2.17)周],差异有统计学意义(P<0.001);外院转运组严重ROP[如病变Ⅰ区、急进性后部型早产儿视网膜病(AP-ROP)、合并Plus病变]所占比例高于本院出生组,差异均有统计学意义(均P<0.001);外院转运组ROP早产儿行激光光凝术、玻璃体注药术、二者联合术、补激光术治疗所占比例均高于本院出生组[60.1%(310/516例)比20.9%(50/239例);10.9%(56/516例)比2.5%(6/239例);8.1%(42/516例)比1.7%(4/239例);4.5%(23/516例)比1.3%(3/239例)],差异均有统计学意义(均P<0.001)。结论外院转运ROP早产儿出生体质量较低,ROP病变较重,手术干预率高。提高基层医院早产儿ROP筛查水平,及时诊断和高效转运可有效防止ROP进一步恶化,提高早产儿生活质量。

Comparative study on the incidence of retinopathy of prematurity in premature infants born in the hospital and transported from other hospitals

Objective To explore the incidence,diagnosis and treatment of retinopathy of prematurity(ROP)in preterm infants born in the Guangdong Women and Children′s Hospital and transported from other hospital.Method s Clinical data of 755 premature infants with ROP at Neonatal Intensive Care Unit,Guangdong Women and Children′s Hospital from January 2013 to December 2015 were retrospectively analyzed.There were 239 cases born in the hospital and 516 cases transported from other hospitals.Their gestational age,birth weight,gender,severity of ROP lesion and clinical data were collected and compared.Result s The birth weight in the group of transported from other hospital was lower than that in the group of born in the hospital[(1290.64±392.87)g vs.(1586.21±512.74)g],and the difference was statistically significant(P<0.001).The ROP diagnosis of gestational age in the group of transported from other hospital was higher than that in the group of born in the hospital[(35.53±2.81)weeks vs.(34.51±2.17)weeks],and the difference was statistically significant(P<0.001).On the proportion of severe condition[such as lesion areaⅠ,aggressive posterior retinopathy of prematurity(AP-ROP)and plus combined lesions],in the group of transported from other hospital was higher than that in the group of born in the hospital,and the differences was statistically significant(P<0.001).In the comparison of the proportion of laser photocoagulation,vitreous injection,combination of the two operations and supplementary laser therapy,in the group of transported from other hospital were higher than those in the group of born in the hospital[60.1%(310/516 cases)vs.20.9%(50/239 cases);10.9%(56/516 cases)vs.2.5%(6/239 cases);8.1%(42/516 cases)vs.1.7%(4/239 cases);4.5%(23/516 cases)vs.1.3%(3/239 cases)],and the differences were statistically significant(all P<0.001).Conclusions Premature infants with ROP transported from other hospitals have lower birth weight,severe ROP lesions and high surgical intervention rate.Improving ROP screening level in primary hospitals,timely diagnosis and efficient transportation can help to effectively prevent the deterioration of ROP in premature infants and improve their quality of life.