CAJ | 학술논문

目的探讨在新生儿重症监护病房(NICU)床边进行早产儿视网膜病变(ROP)激光治疗的临床效果及围手术期安全性.方法回顾性分析2009年3月至2011年7月,在八一儿童医院NICU内采取机械通气下肌松剂麻醉后,床边进行激光治疗的103例ROP患儿的临床资料.结果 103例严重ROP患儿共199只眼接受了激光治疗(随访最短5个月),其中Ⅰ区病变39例76只眼(38.2％),Ⅱ区病变64例123只眼(61.8％),有附加病变91例180只眼(90.5％),经治疗后191只眼病变消退,8只眼发展至局部视网膜脱离,总体治愈率96.0％,其中Ⅰ区89.5％,Ⅱ区100％.103例患儿无一例出现术中风险,术后平均撤离呼吸机时间为(6.7±1.3)h.结论 NICU床边进行严重ROP激光治疗是一种安全、有效的治疗模式,值得推广.
목적 탐토재신생인중증감호병방(NICU)상변진행조산인시망막병변(ROP)격광치료적림상효과급위수술기안전성.방법 회고성분석2009년3월지2011년7월,재팔일인동의원NICU내채취궤계통기하기송제마취후,상변진행격광치료적103례ROP환인적림상자료.결과 103례엄중ROP환인공199지안접수료격광치료(수방최단5개월),기중Ⅰ구병변39례76지안(38.2％),Ⅱ구병변64례123지안(61.8％),유부가병변91례180지안(90.5％),경치료후191지안병변소퇴,8지안발전지국부시망막탈리,총체치유솔96.0％,기중Ⅰ구89.5％,Ⅱ구100％.103례환인무일례출현술중풍험,술후평균철리호흡궤시간위(6.7±1.3)h.결론 NICU상변진행엄중ROP격광치료시일충안전、유효적치료모식,치득추엄.
Objective To evaluate the efficacy and safety of the bedside diode laser photocoagulation for severe retinopathy of prematurity in neonatal intensive care unit (NICU).Method Data of 103 patients with prethreshold or threshold retinopathy of prematurity (ROP),treated with diode laser photoablation after vecuronium-induced anesthesia and mechanical ventilation from March 2009 to July 2011 in NICU of Bayi Children's Hospital.Result Totally 199 eyes in 103 patients received laser therapy with at least 5 months follow up.Among these eyes,zone Ⅰ disease was found in 76 eyes(38.2％)of 39 infants,zone Ⅱ disease was found in 123 eyes(61.8％)of 64 infants and additional disease was found in 180 eyes of 91 infants.After treatment 191 (96.0％) of 199 eyes had favorable outcomes and 8 developed to partial retinal detachment.The rate of favorable outcomes in zone Ⅰ diseases and zone 2 diseases were 89.5％ and 100％ respectively.The laser therapy was undertaken in all patients safely and the use of ventilator was stopped quickly [after a mean of (6.7 ± 1.3) h].Conclusion Bedside laser photocoagulation in NICU is a safe and effective treatment mode for severe ROP and should be used widely.