CAJ | 학술논문

目的：探讨超早产儿中早产儿视网膜病(retinopathy of prematurity,ROP)的发病率,并分析其中重症 ROP 的治疗方法与临床效果。方法对我院2006年4月至2013年10月出生并存活至少1年以上的胎龄〈28周的96例超早产儿进行回顾性分析,了解 ROP 的发病率,并分析激光光凝术及玻璃体腔内注入血管内皮生长因子抗体(雷珠单抗)治疗重症 ROP 患儿的方法、时机及疗效。结果96例超早产儿中共发生 ROP 56例,总发病率58.33%。其中重症 ROP 21例,占总 ROP 的37.5%,占总存活婴儿的21.88%,包括急进性后极 ROP 患儿2例(2.08%)。对重症 ROP 患儿中的15例给予单纯激光光凝术治疗；另6例先予玻璃体腔注入雷珠单抗,其中4例在1个月后加用激光光凝术治疗,2例无需再进行激光光凝术。全部患儿均保留视力,成功率100%。结论超早产儿中 ROP 发病率及重症发病率均非常高,应列为重点筛查对象；重症 ROP 患儿需及时进行激光光凝术,病情危重或急进性后极 ROP患儿可结合使用血管内皮生长因子抗体治疗。
목적：탐토초조산인중조산인시망막병(retinopathy of prematurity,ROP)적발병솔,병분석기중중증 ROP 적치료방법여림상효과。방법대아원2006년4월지2013년10월출생병존활지소1년이상적태령〈28주적96례초조산인진행회고성분석,료해 ROP 적발병솔,병분석격광광응술급파리체강내주입혈관내피생장인자항체(뢰주단항)치료중증 ROP 환인적방법、시궤급료효。결과96례초조산인중공발생 ROP 56례,총발병솔58.33%。기중중증 ROP 21례,점총 ROP 적37.5%,점총존활영인적21.88%,포괄급진성후겁 ROP 환인2례(2.08%)。대중증 ROP 환인중적15례급여단순격광광응술치료；령6례선여파리체강주입뢰주단항,기중4례재1개월후가용격광광응술치료,2례무수재진행격광광응술。전부환인균보류시력,성공솔100%。결론초조산인중 ROP 발병솔급중증발병솔균비상고,응렬위중점사사대상；중증 ROP 환인수급시진행격광광응술,병정위중혹급진성후겁 ROP환인가결합사용혈관내피생장인자항체치료。
Objective To analyze the incidence of retinopathy of prematurity(ROP)among extreme-ly preterm infants,and to evaluate the treatment methods and effects among those with severe ROP.Methods A retrospective analysis was performed to analyze incidence of ROP in 96 cases of extremely preterm infants who were born at a gestational age of 〈28 weeks and survived beyond a postmenstrual age of at least 1 year from Apr 2006 to Oct 2013,and to analyze the treatment outcomes of photocoagulation and ranibizum-ab intravitreal injection among the infants with severe ROP.Results Fifty-six of 96 cases(58.33%)grew into ROP finally and 21 cases(21.88%)grew into severe ROP,2 cases(2.08%)grew into aggressive poste-rior ROP.Fifteen cases with severe ROP were treated with laser photocoagulation.Four cases with severe ROP were received ranibizumab intravitreal injection prior to photocoagulation.Two cases with severe ROP were only treated with ranibizumab intravitreal injection.The eyesight of 96 patients (100%)in this study were all preserved.Conclusion ROP screening should focus on extremely preterm infants because of higher incidence of ROP and severe ROP among them.The infants with severe ROP should be treated with laser photocoagulation in time.The infants in critical condition or with aggressive posterior ROP can be treated with ranibizumab injection.