多生子早产儿视网膜病变临床分析

目的分析多生子早产儿视网膜病变(ROP)的发生及发展特点。方法选取2084例出生后4~6周或矫正胎龄32周的早产儿作为研究对象,使用RetCamⅢ进行眼底筛查,对于达到阈值及阈值前病变的再进行双目间接眼底镜检查。比较多生子与单生子ROP发病情况, ROP多生子与ROP单生子的孕周、出生体质量。结果 2084例早产儿中, ROP发病率为14.64%(305/2084)。其中709例多生子中共筛查出ROP 120例(16.93%);1375例单生子中共筛查出ROP 185例(13.45%)。多生子ROP发病率高于单生子,差异具有统计学意义(χ²=4.510, P<0.05)。ROP多生子孕周<30周占比为44.17%(53/120)高于单生子的30.27%(56/185),差异有统计学意义(χ²=6.120, P<0.05);ROP多生子孕周30~33周和>33周占比与ROP单生子比较差异无统计学意义(P>0.05)。ROP多生子出生体质量<1000 g占比为57.50%(69/120)高于单生子的45.41%(84/185),差异有统计学意义(χ²=4.259, P<0.05);ROP多生子出生体质量1000~1500 g和>1500 g占比与ROP单生子比较,差异无统计学意义(P>0.05)。结论多生子ROP发病率高于单生子,且胎龄短、出生体质量低是多生子ROP发病的危险因素。

Clinical analysis of retinopathy of prematurity in multiple births

Objective To analyze the occurrence and development of retinopathy of prematurity(ROP)in multiple births.Methods 2084 cases of preterm infants of 4-6 weeks after birth or 32 weeks after corrected gestational age were selected as the research subjects,and Ret CamⅢwas used for fundus screening.For the lesions that reached the threshold and before the threshold,the binocular indirect ophthalmoscope was performed to confirm the diagnosis.Comparison was made on the incidence of ROP in single birth and multiple births,and the gestational age and birth weight of multiple births and single births in ROP.Results The incidence of ROP was 14.64%(305/2084)among 2084 preterm infants.Among them,120 cases(16.93%)of ROP were screened out in 709 multiple preterm infants,and 185 cases(13.45%)of ROP were screened out in 1375 single preterm infants.The incidence of ROP in multiple births was higher than that in single birth,and the difference was statistically significant(χ²=4.510,P<0.05).The proportion of ROP multiple births<30 weeks was 44.17%(53/120),which was higher than 30.27%(56/185)of single births,and the difference was statistically significant(χ²=6.120,P<0.05);there was no statistically significant difference in the proportion of ROP multiple births at 30-33 weeks of gestation and>33 weeks compared with ROP single birth(P>0.05).The proportion of birth weights of ROP multiple births<1000 g was 57.50%(69/120),which was higher than 45.41%(84/185)of single births,and the difference was statistically significant(χ²=4.259,P<0.05);there was no statistically significant difference in the proportion of birth weights of 1000-1500 g and>1500 g between ROP multiple births and ROP single birth(P>0.05).Conclusion The incidence of ROP in multiple births is higher than that in single birth,and short gestational age and low birth weight are risk factors for ROP in multiple births.