摘要
目的探讨早产儿视网膜病变（ROP）的发生率及高危因素，初步评价2004年早产儿治疗用氧和视网膜病变防治指南在ROP筛查中的实用性。方法对2011年2月至2012年2月在四川大学华西第二医院住院治疗且符合筛查标准的218例早产儿进行眼底检查，并分析发生ROP的相关因素。按英国推荐的ROP筛查标准（体质量≤1500g或胎龄≤31周）对筛查结果进行比较。结果218例早产儿中，11例发生ROP，发生率为5．0％。ROP组与非ROP组10minApgar评分分别为（8．60±1．78）分及（9．53±0．98）分，合并呼吸窘迫综合征例数分别为6例及33例，吸氧时间〉10d的患儿分别为8例及44例，使用机械通气患儿例数分别为6例及23例，使用输血治疗的早产儿分别为6例及53例，上述指标2组间比较差异均有统计学意义（P均〈0．05）。若按英国推荐的ROP筛查标准统计，将遗漏7例。结论出生后Apgar评分较低、病程中吸氧时间长、使用机械通气或伴有严重全身并发症与ROP的发生有关，在进行ROP筛查时使用2004卫生部推荐指南符合本地区的实际情况，但应根据患儿全身疾病情况尤其是并呼吸窘迫综合征的患儿有选择地进行筛查可减少漏诊率。
Objective To explore the risk factors and morbidity of retinopathy of prematurity（ROP） and eva- luate the appropriateness of the ROP screening criteria set by Ministry of Health in 2004. Methods Two hundred and eighteen premature infants conforming to the criteria set by Ministry of Health in 2004, who were hospitalized in West China Second Hospital from Feb. 2011 to Feb. 2012, were enrolled, and they underwent ophthalmologie examination. The results were analyzed and compared according to criteria recommended by the United Kingdom （weight ≤ 1500 g or ges- tational age ≤31 weeks）. Results In the 218 premature infants, 11 （ 5.0% ） cases had developed ROP. Between the groups of ROP and the contrast,the Apgar scores were 8.60 ± 1.78 and 9.53 ± 0.98, and the cases of patients with re- spiratory distress syndrome were 6 cases and 33 cases respectively, while the cases of patients with long-term oxygen therapy were 8 cases and 44 cases, the cases of patients with mechanical ventilation were 6 cases and 23 cases, while the cases of patients with transfusion therapy were 6 cases and 53 cases, respectively. And there were significant diffe- rences between the two groups（ all P 〈 0.05 ）. There would have been 7 cases of ROP to be missed if the screening had been done in according to British guidelines. Conclusions There is a possible association between low Apgar scores, long-term oxygen therapy, mechanical ventilation and the incidence of ROP. The ROP screening criteria set by Ministry of Health in 2004 is practical for ROP screening in our region in China. ROP screening should also be done for the pre- mature infants who had unstable clinical course, and respiratory distress syndrome in oarticular.
出处
《中华实用儿科临床杂志》
CAS
CSCD
北大核心
2013年第14期1058-1060,共3页
Chinese Journal of Applied Clinical Pediatrics
基金
国家重大科学研究计划项目（2013CB967404）
教育部长江学者和创新团队基金（IRT0935）
教育部博士学科点专项科研基金（20110181130002）：四川省科技厅科技支撑项目（2010SZ0280）
国家临床重点专科（儿科新生儿专业）建议项目经费资助
