摘要
目的研究出生体质量超过1500g早产儿严重早产儿视网膜病变(retinopathy of prematurity,ROP)发病特点及其治疗预后。方法收集2006年1月至2009年6月在我院进行激光光凝治疗的阈值、阈值前1型或急进型后部ROP(aggressive posterior ROP,AP-ROP)患儿中,选择出生体质量>1500g患儿,对其性别、胎龄、出生体质量、母体和患儿全身疾病情况等危险因素进行分析,并对其治疗效果进行评价。结果共收集患儿33例,男26例,女7例;胎龄28.0～34.3周,平均31.0周;出生体质量为1500～2000g,平均1700g;剖宫产19例,顺产14例。所有患儿均有吸氧史,母体合并全身疾病者27例;术前诊断13例26眼为阈值前1型ROP,3例6眼为AP-ROP,17例34眼为阈值ROP。26例52眼患儿一次光凝成功,5例10眼补充光凝成功,1例2眼经Avastin玻璃体腔注射后病变稳定,1例2眼病变发展至4期和5期行玻璃体手术后病情控制、稳定。结论出生体质量超过1500g早产儿患严重ROP现象反映本地区ROP防治水平低,早产儿出生前母体全身情况不稳定是造成ROP发病的重要原因之一,该类型ROP病变一般较轻,治疗预后较好。
Objective To study the clinical characteristics and prognosis of severe retinopathy of prematurity（ROP） with birth mass more than 1 500 g.Methods From January 2006 to June 2009,the cases with birth mass greater than or equal to 1 500 g from all the infants in our hospital,who suffered from threshold,pre-threshold（type 1） or aggressive posterior ROP,were selected and underwent laser photocoagulation.The risk factors such as gender,gestational age,birth mass,maternal or infantile systemic disease were analyzed,and their therapeutic efficacy were evaluated.Results Thirty-three cases were found,26 cases were male,7 cases were female;Gestational age were from 28.0 weeks to 34.3 weeks,mean 31.0 weeks;birth mass were from 1 500 g to 2 000 g,mean1 700 g;Nineteen cases were born by caesarean section and 14 cases by natural delivery.All patients had oxygen therapy history,27 cases had maternal systemic disease problems.Preoperative diagnosis：13 cases（26 eyes） were pre-threshold ROP（type 1）,3 cases（6 eyes） was AP-ROP,17 cases（34 eyes） were threshold ROP.Treatment results：The first surgery was successful in 26 cases（52 eyes）,the supplemental photocoagulation was given in 5 cases（10 eyes）.The fundus was stable in 1 case（2 eyes） by avastin intravitreal injection.At last,stage 4 or 5 ROP occurred in 1 case（2 eyes） whose disease was controlled after vitreous surgery.Conclusions The condition of severe ROP cases with birth weight more than 1 500g reflects the low level of prematurity therapy.The important factors to induce severe ROP relate to maternal systemic illness.This type of ROP is relatively mild with a better prognosis.
出处
《眼科新进展》
CAS
北大核心
2011年第8期751-753,共3页
Recent Advances in Ophthalmology
基金
2009年深圳市科技计划项目(编号:200902123)~~
关键词
早产儿视网膜病变
阈值病变
视网膜光凝
retinopathy of prematurity
threshold disease
photocoagulation
