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目的了解我院早产儿视网膜病变(ROP)的发病状况,探讨其危险因素。方法选择2011年1月至2012年12月在我院新生儿科住院并符合入选标准的早产儿(胎龄≤36周,体重≤2500 g,出生后需要吸氧),生后2周进行ROP筛查,并定期随访。将患儿全身状况和吸氧情况,以及母孕期吸氧、先兆子痫、胎盘早剥等因素进行统计分析。结果 255例患儿完成了全部眼底筛查,在周边视网膜血管化或病变退化后终止随访。发现ROP 16例(26只眼),ROP患病率为6.3%(5.1%),其中I期12例,Ⅱ期3例,Ⅲ期1例。多因素Logistic回归分析显示,胎龄(OR=0.220,95%CI 0.120~0.490)、出生体重(OR=1.235,95%CI 1.109~2.872)、吸氧时间(OR=2.329,95%CI 1.044~3.531),吸氧浓度(OR=1.881,95%CI 2.268~18.973)、机械通气(OR=1.924,95%CI 2.014~17.615)与ROP相关(P均<0.05)。结论早产、出生体重低、吸氧浓度高、吸氧时间长和机械通气是ROP的主要危险因素。对早产儿适时进行ROP筛查,早期对发现的ROP患儿进行有效视网膜激光光凝术,可提高早产儿日后生存质量。
Objective To understand the incidence of retinopathy of prematurity (ROP) in our hospital and explore its risk factors. Methods Preterm infants (gestational age ≤36 weeks, body weight ≤2500 g, need oxygen after birth) who were hospitalized in our department of neonatology from January 2011 to December 2012 were enrolled. After 2 weeks of life, ROP Check, and regular follow-up. The status of children with general oxygen and oxygen situation, as well as the first trimester oxygen, preeclampsia, placental abruption and other factors for statistical analysis. Results A total of 255 children underwent complete fundus screening and the follow-up was terminated after peripheral retinal vascularization or lesion degeneration. ROP was found in 16 cases (26 eyes), the prevalence of ROP was 6.3% (5.1%), of which 12 cases were in stage I, 3 cases in stage II and 1 in stage III. Multivariate logistic regression analysis showed that gestational age (OR = 0.220, 95% CI 0.120-0.490), birth weight (OR = 1.235,95% CI 1.109-2.872), oxygen inhalation time (OR = 2.329, 95% CI 1.044 ~ (OR = 1.881, 95% CI 2.268 ~ 18.973), and mechanical ventilation (OR = 1.924, 95% CI 2.014 ~ 17.615) correlated with ROP (all P <0.05). Conclusion Preterm birth, low birth weight, high oxygen concentration, long duration of oxygen inhalation and mechanical ventilation are the main risk factors for ROP. ROP timely screening of premature children, early detection of ROP in children with effective retinal laser photocoagulation, can improve the quality of life of premature children in the future.