目的探讨早产儿视网膜病(ROP)的早期诊治及危险因素。方法对本院新生儿科2004年7月至2006年6月共收治胎龄<34周或出生体重<2000g的住院早产儿,在纠正胎龄32~34周或生后4~6周时,由眼科医生用间接眼底镜进行ROP筛查,根据筛查结果将患儿分为ROP组和眼底正常组,对于检出阈值病变的患儿全部给予眼底激光凝固术治疗,对所有临床资料进行回顾性分析。结果2年期间我科共收治早产儿785例,符合筛查标准的早产儿395例,共发现ROP 90例,发生率占筛查病人的22.8%;其中阈值病变24例(占筛查病人的6.1%)。22例阈值病变患儿接受了眼底激光凝固术治疗,随访1年全部保存视力,2例家长放弃治疗的患儿,1年后随访均失明。未达阈值病变的ROP患儿定期随访,半年后病变消退。将ROP组与正常眼底组比较,单因素分析提示:ROP组的胎龄较正常眼底组低,(31.10±1.96)周比(33.21±1.73)周,差异有统计学意义(t=9.569.P<0.001);ROP组的出生体重较正常眼底组低,(1 508±312)g比(1900±350)g,差异有统计学意义(t=9.859,P<0.001);ROP组的吸氧时间较正常眼底组长,差异有统计学意义(P<0.001)。与正常眼底组相比,ROP组更多合并窒息、肺透明膜病、贫血(P<0.05)。Logistic多元回归分析提示:胎龄小(OR=0.709,P<0.05)、体重低(OR=0.179,P<0.05)、吸氧时间>5d(OR=5.474,P<0.001)是ROP的危险因素。结论ROP的发生与多因素有关,出生体重越小、胎龄越小、氧疗时间越长ROP的危险性越大,防治ROP的关键在于早期进行眼底筛查和及时对阈值病变进行治疗。 Objective To investigate the early diagnosis and treatment of retinopathy of prematurity (ROP) and its risk factors. Methods In our hospital, neonates from July 2004 to June 2006 were admitted to preterm infants with gestational age <34 weeks or birth weight <2000g. After corrected gestational age of 32 to 34 weeks or 4 to 6 weeks after birth, Ophthalmologists used indirect ophthalmoscopy for ROP screening. According to the results of screening, they were divided into ROP group and normal fundus group. All patients with threshold lesion were treated by fundus laser photocoagulation. All clinical data were retrospectively analyzed analysis. Results A total of 785 preterm children and 395 premature children who met the screening criteria were treated in our department during 2 years. A total of 90 ROPs were detected in our department, accounting for 22.8% of the screening patients. Threshold lesions of 24 patients (accounting for screening patients 6.1%). Twenty-two children with thresholding underwent fundus laser photocoagulation. One year after follow-up, all children with visual acuity were preserved. Two children who gave up their treatment after one year of follow-up were blind. ROP children less than the threshold lesions were followed up regularly, and the disease subsided after six months. Univariate analysis showed that the gestational age of ROP group was lower than that of normal fundus group (31.10 ± 1.96 weeks vs 33.21 ± 1.73 weeks, the difference was statistically significant (t = 9.569.P <0.001). The birth weight of ROP group was lower than that of normal fundus group (1 508 ± 312) g (1900 ± 350) g, the difference was statistically significant (t = 9.859, P <0.001) The time was longer than normal fundus group, the difference was statistically significant (P <0.001). Compared with the normal fundus group, ROP group more complicated with asphyxia, hyaline membrane disease, anemia (P <0.05). Logistic multivariate regression analysis showed that the gestational age was lower (OR = 0.709, P <0.05), lower body weight (OR = 0.179, P <0.05) and oxygen inhalation time> 5 days . Conclusions The occurrence of ROP is related to multiple factors. The smaller the birth weight, the smaller the gestational age and the longer the duration of oxygen therapy, the greater the risk of ROP. The key to prevention and treatment of ROP is early fundus screening and timely treatment of thrombosis.