中华妇幼临床医学杂志（电子版）
中華婦幼臨床醫學雜誌（電子版）
중화부유림상의학잡지（전자판）
CHINESE JOURNAL OF OBSTETRICS & GYNECOLOGY AND PEDIATRICS(ELECTRONIC VERSION)
2012年
2期
164-167
,共4页
张应金%黄建伟%黄润忠%梁凤潇%苏永棉%张金凤%廖南萍
張應金%黃建偉%黃潤忠%樑鳳瀟%囌永棉%張金鳳%廖南萍
장응금%황건위%황윤충%량봉소%소영면%장금봉%료남평
早产儿%早产儿视网膜病%筛查%危险因素%新生儿
早產兒%早產兒視網膜病%篩查%危險因素%新生兒
조산인%조산인시망막병%사사%위험인소%신생인
premature newborn%retinopathy of prematurity%neonatal screening%risk factor
目的 了解早产儿视网膜病变(ROP)的发生状况,并探讨ROP的相关危险因素.方法 选择2009年1月至2010年12月在本院新生儿科住院的250例早产儿为研究对象,胎龄≤36孕周,出生体重≤2500 g.于生后第14天对其进行ROP筛查,记录早产儿一般临床资料.早产儿完成ROP筛查后,对其随访至周边视网膜新生血管形成或病变退化(本研究遵循的程序符合本院人体试验委员会制定的伦理学标准,得到该委员会批准,并与受试对象监护人签订临床研究知情同意书).采用非条件logistic多元回归分析法进行ROP相关危险因素[胎龄、胎次、出生体重、性别、吸氧持续时间及浓度、机械通气治疗、是否合并新生儿窒息、呼吸暂停、呼吸窘迫综合征(RDS)并发症及是否输血等]分析.结果 250例早产儿全部完成ROP筛查,共计检出ROP 16例(26只眼),ROP发生率分别为6.4％(16/250,ROP患儿发病率)和5.2％(26/500,ROP眼发病率),其中ROP 1期为12例(75.0％),2期为3例(18.8％),3期为1例(6.3％).非条件logistic ROP相关危险因素分析结果显示,ROP与早产儿胎龄、吸氧持续时间及浓度、接受机械通气治疗密切相关(OR=0.668,95％CI:-0.721～-0.088,P=0.012;OR=7.768,95％CI:0.608～3.492,P=0.005; OR=5.241,95％CI:0.191～3.121,P=0.027;OR=1.235,95％CI:1.109～2.872,P=0.001);其余因素与ROP无相关关系(P＞0.05).结论 早产、吸氧持续时间长及浓度高、接受机械通气治疗是发生ROP的主要危险因素.对早产儿适时进行ROP筛查,可为临床防治ROP提供理论依据.
目的 瞭解早產兒視網膜病變(ROP)的髮生狀況,併探討ROP的相關危險因素.方法 選擇2009年1月至2010年12月在本院新生兒科住院的250例早產兒為研究對象,胎齡≤36孕週,齣生體重≤2500 g.于生後第14天對其進行ROP篩查,記錄早產兒一般臨床資料.早產兒完成ROP篩查後,對其隨訪至週邊視網膜新生血管形成或病變退化(本研究遵循的程序符閤本院人體試驗委員會製定的倫理學標準,得到該委員會批準,併與受試對象鑑護人籤訂臨床研究知情同意書).採用非條件logistic多元迴歸分析法進行ROP相關危險因素[胎齡、胎次、齣生體重、性彆、吸氧持續時間及濃度、機械通氣治療、是否閤併新生兒窒息、呼吸暫停、呼吸窘迫綜閤徵(RDS)併髮癥及是否輸血等]分析.結果 250例早產兒全部完成ROP篩查,共計檢齣ROP 16例(26隻眼),ROP髮生率分彆為6.4％(16/250,ROP患兒髮病率)和5.2％(26/500,ROP眼髮病率),其中ROP 1期為12例(75.0％),2期為3例(18.8％),3期為1例(6.3％).非條件logistic ROP相關危險因素分析結果顯示,ROP與早產兒胎齡、吸氧持續時間及濃度、接受機械通氣治療密切相關(OR=0.668,95％CI:-0.721～-0.088,P=0.012;OR=7.768,95％CI:0.608～3.492,P=0.005; OR=5.241,95％CI:0.191～3.121,P=0.027;OR=1.235,95％CI:1.109～2.872,P=0.001);其餘因素與ROP無相關關繫(P＞0.05).結論 早產、吸氧持續時間長及濃度高、接受機械通氣治療是髮生ROP的主要危險因素.對早產兒適時進行ROP篩查,可為臨床防治ROP提供理論依據.
목적 료해조산인시망막병변(ROP)적발생상황,병탐토ROP적상관위험인소.방법 선택2009년1월지2010년12월재본원신생인과주원적250례조산인위연구대상,태령≤36잉주,출생체중≤2500 g.우생후제14천대기진행ROP사사,기록조산인일반림상자료.조산인완성ROP사사후,대기수방지주변시망막신생혈관형성혹병변퇴화(본연구준순적정서부합본원인체시험위원회제정적윤리학표준,득도해위원회비준,병여수시대상감호인첨정림상연구지정동의서).채용비조건logistic다원회귀분석법진행ROP상관위험인소[태령、태차、출생체중、성별、흡양지속시간급농도、궤계통기치료、시부합병신생인질식、호흡잠정、호흡군박종합정(RDS)병발증급시부수혈등]분석.결과 250례조산인전부완성ROP사사,공계검출ROP 16례(26지안),ROP발생솔분별위6.4％(16/250,ROP환인발병솔)화5.2％(26/500,ROP안발병솔),기중ROP 1기위12례(75.0％),2기위3례(18.8％),3기위1례(6.3％).비조건logistic ROP상관위험인소분석결과현시,ROP여조산인태령、흡양지속시간급농도、접수궤계통기치료밀절상관(OR=0.668,95％CI:-0.721～-0.088,P=0.012;OR=7.768,95％CI:0.608～3.492,P=0.005; OR=5.241,95％CI:0.191～3.121,P=0.027;OR=1.235,95％CI:1.109～2.872,P=0.001);기여인소여ROP무상관관계(P＞0.05).결론 조산、흡양지속시간장급농도고、접수궤계통기치료시발생ROP적주요위험인소.대조산인괄시진행ROP사사,가위림상방치ROP제공이론의거.
Objective To investigate the screening of retmopathy of prematurity ( ROP) and its related risk factors.Methods From January 2009 to December 2010,a total of 250 preterm newborns were recruited into this study.The gestational ages were less than 36 gestational weeks,birth weights were under 2500 g.All the cases underwent ROP screening at one week after birth,and then received regular follow-up until peripheral retinal neovascularization or lesion degradation.The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Maternal and Child Health Hospital of Shunde,Jinan University.Informed consent was obtained from the parents of each participating neonate.The relationship among ROP and systemic conditions and oxygen inhalation of newborns,oxygen inhalation volume of mother during pregnancy,preeclampsia,placental abruption and other factors were analyzed,respectively.Results All the 250 newborns completed the retinal screening.A total of 16 newborns (26 eyes) were found ROP,and the prevalence rate of ROP were 6.4％ (16/250) and 5.2％ (26/500),respectively,in which 12 cases (75.0％) of grade 1,3(18.8％) of grade 2 and 1 (6.3％)of grade 3.Univariate analysis of risk factors of ROP showed gestational age,birth weight,oxygen inhalation time,oxygen inhalation concentration,mechanical ventilation were associated with ROP (P＜ 0.05).Oxygen inhalation during pregnancy,preeclampsia,placental abruption had no correlation with ROP(P＞ 0.05).Conclusions Premature birth,high concentrations of oxygen inhalation,mechanical ventilation are major risk factors of ROP.Preterm newborns should have regular screening and follow-up in order to find the lesion as soon as possible to decrease the incidence rate of blindness.
