中华围产医学杂志
中華圍產醫學雜誌
중화위산의학잡지
CHINESE JOURNAL OF PERINATAL MEDICINE
2013年
2期
71-75
,共5页
李秋平%周细中%章晟%黄俊谨%陈颖%王自珍%柯艳%封志纯
李鞦平%週細中%章晟%黃俊謹%陳穎%王自珍%柯豔%封誌純
리추평%주세중%장성%황준근%진영%왕자진%가염%봉지순
视网膜病,早产儿%新生儿筛查%婴儿,早产%危险因素
視網膜病,早產兒%新生兒篩查%嬰兒,早產%危險因素
시망막병,조산인%신생인사사%영인,조산%위험인소
Retinopathy of prematurity%Neonatal screening%Infant,premature%Risk factors
目的 了解早产儿视网膜病变(retinopathy of prematurity,ROP)发生率及高危因素.方法 2009年1月1日至2010年12月31日,采用RetCamⅡ数字视网膜照相机对入住北京军区总医院附属八一儿童医院新生儿重症监护病房的2185例胎龄≤34周或出生体重≤2000 g的早产儿进行眼底筛查,根据筛查结果分成ROP组和非ROP组,计算ROP的发生率,并采用单因素分析和Logistic回归分析探讨ROP的危险因素.结果 接受眼底筛查的2185例早产儿中,共发生ROP287例,发生率为13.1％.按国际ROP分类标准,Ⅰ区病变34例、Ⅱ区病变147例、Ⅲ区病变106例,分别占11.9％、51.2％和36.9％.1、2、3期病变分别为11 7例、142例和28例,分别占40.8％、49.5％和9.7％,未发现4、5期病变.其中36例患儿发现附加病变,占12.5％.Logistic回归分析显示,胎龄小(OR=0.859,95％ CI:0.770～0.958,P=0.006)、出生体重低(OR=0.729,95％CI:0.634～0.838,P=0.000)、吸氧时间长(OR=2.221,95％CI:1.904～2.592,P=0.000)、辅助通气(OR=3.104,95％ CI:2.096～4.956,P=0.000)、呼吸暂停(OR=1.767,95％ CI:1.103～2.831,P=0.018)和贫血(OR=2.242,95％CI:1.641～3.604,P=0.000)是早产儿发生ROP的独立危险因素.结论 早产儿ROP发生率较高,低胎龄、低出生体重、吸氧时间长、辅助通气、呼吸暂停和贫血是其主要危险因素,临床上应针对以上因素采取相关措施,从而降低ROP发生率.
目的 瞭解早產兒視網膜病變(retinopathy of prematurity,ROP)髮生率及高危因素.方法 2009年1月1日至2010年12月31日,採用RetCamⅡ數字視網膜照相機對入住北京軍區總醫院附屬八一兒童醫院新生兒重癥鑑護病房的2185例胎齡≤34週或齣生體重≤2000 g的早產兒進行眼底篩查,根據篩查結果分成ROP組和非ROP組,計算ROP的髮生率,併採用單因素分析和Logistic迴歸分析探討ROP的危險因素.結果 接受眼底篩查的2185例早產兒中,共髮生ROP287例,髮生率為13.1％.按國際ROP分類標準,Ⅰ區病變34例、Ⅱ區病變147例、Ⅲ區病變106例,分彆佔11.9％、51.2％和36.9％.1、2、3期病變分彆為11 7例、142例和28例,分彆佔40.8％、49.5％和9.7％,未髮現4、5期病變.其中36例患兒髮現附加病變,佔12.5％.Logistic迴歸分析顯示,胎齡小(OR=0.859,95％ CI:0.770～0.958,P=0.006)、齣生體重低(OR=0.729,95％CI:0.634～0.838,P=0.000)、吸氧時間長(OR=2.221,95％CI:1.904～2.592,P=0.000)、輔助通氣(OR=3.104,95％ CI:2.096～4.956,P=0.000)、呼吸暫停(OR=1.767,95％ CI:1.103～2.831,P=0.018)和貧血(OR=2.242,95％CI:1.641～3.604,P=0.000)是早產兒髮生ROP的獨立危險因素.結論 早產兒ROP髮生率較高,低胎齡、低齣生體重、吸氧時間長、輔助通氣、呼吸暫停和貧血是其主要危險因素,臨床上應針對以上因素採取相關措施,從而降低ROP髮生率.
목적 료해조산인시망막병변(retinopathy of prematurity,ROP)발생솔급고위인소.방법 2009년1월1일지2010년12월31일,채용RetCamⅡ수자시망막조상궤대입주북경군구총의원부속팔일인동의원신생인중증감호병방적2185례태령≤34주혹출생체중≤2000 g적조산인진행안저사사,근거사사결과분성ROP조화비ROP조,계산ROP적발생솔,병채용단인소분석화Logistic회귀분석탐토ROP적위험인소.결과 접수안저사사적2185례조산인중,공발생ROP287례,발생솔위13.1％.안국제ROP분류표준,Ⅰ구병변34례、Ⅱ구병변147례、Ⅲ구병변106례,분별점11.9％、51.2％화36.9％.1、2、3기병변분별위11 7례、142례화28례,분별점40.8％、49.5％화9.7％,미발현4、5기병변.기중36례환인발현부가병변,점12.5％.Logistic회귀분석현시,태령소(OR=0.859,95％ CI:0.770～0.958,P=0.006)、출생체중저(OR=0.729,95％CI:0.634～0.838,P=0.000)、흡양시간장(OR=2.221,95％CI:1.904～2.592,P=0.000)、보조통기(OR=3.104,95％ CI:2.096～4.956,P=0.000)、호흡잠정(OR=1.767,95％ CI:1.103～2.831,P=0.018)화빈혈(OR=2.242,95％CI:1.641～3.604,P=0.000)시조산인발생ROP적독립위험인소.결론 조산인ROP발생솔교고,저태령、저출생체중、흡양시간장、보조통기、호흡잠정화빈혈시기주요위험인소,림상상응침대이상인소채취상관조시,종이강저ROP발생솔.
Objective To determine the incidence and risk factors of retinopathy of prematurity (ROP) in preterm infants.Methods Fundus examinations were performed by RetCam Ⅱ ophthalmoscopy on 2185 premature infants (birth weight ≤ 2000 g or gestational age≤34 weeks)admitted into the neonatal intensive care unit of Beijing Bayi Children's Hospital from January 1st 2009 to December 31st 2010.According to the results,all infants were divided into ROP group and nonRO P group.Two-sample t test and Logistic regression analysis were used to investigate the risk factors of ROP.Results Among 2185 premature infants,287 (13.1 ％) cases were diagnosed with RO P.According to International Classification of RO P,34 cases (11.9 ％) were in zone Ⅰ,147 cases (51.2％) in zone Ⅱ,and 106 cases(36.9％) in zone Ⅲ.And there were 117 cases (40.8％) with stage 1 lesion,142 cases (49.5％) with stage 2 lesion,28 cases (9.7％) with stage 3 lesion,and no stage 4 or 5 lesion was identified.Thirty-six cases (12.5 ％) were accompanied by additional diseases.Logistic analysis showed that small gestational age (OR=0.859,95％CI:0.770-0.958,P=0.006),low birth weight (OR=0.729,95％CI:0.6340.838,P=0.000),long duration of oxygen supplement (OR=2.221,95％CI:1.904-2.592,P=0.000),assistant ventilation (OR=3.104,95％CI:2.0964.956,P=0.000),apnea (OR=1.767,95％CI:1.103 2.831,P=0.018) and =anemia (OR=2.242,95％CI:1.641-3.604,P=0.000) were independent risk factors of ROP.Conclusions The incidence of ROP in premature infants is high.Small gestational age and low birth weight,long duration of oxygen supplement,assistant ventilation,apnea and anemia are risk factors of ROP.Preventive measures should be taken against these factors.
