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779例新生儿眼底筛查结果及新生儿眼底疾病高危因素分析 被引量:38

Results of 779 cases of neonatal fundus screening and risk factors for neonatal fundus diseases
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摘要 目的应用广角数码视网膜成像系统(Ret Cam3)进行新生儿眼底筛查,了解早产儿及足月小于胎龄儿视网膜疾病的患病率及影响因素。方法回顾性分析2013年1~12月在我院新生儿病房行Ret Cam3眼底筛查的早产儿及足月小于胎龄儿的临床病例资料。结果 779例早产儿及足月小于胎龄儿接受筛查,检出有眼底病变患儿100例(12.8%),其中视网膜出血69例(8.9%)、早产儿视网膜病(ROP)10例(1.3%)、眼底渗出9例(1.2%)、视网膜有髓神经纤维4例(0.5%)、视网膜色素沉着3例(0.4%)、先天性白内障和结晶样变性各2例(0.3%)、视网膜母细胞瘤1例(0.1%)。Logistic回归分析表明低出生体重、胎龄小和有吸氧史是ROP发病的高危因素(分别OR=0.209、0.248、0.049,均P〈0.01);阴道分娩和有机械通气史是导致视网膜出血的高危因素(分别OR=3.196、1.731,均P〈0.05)。结论新生儿眼底病变多样且危害严重,早产儿及足月小于胎龄儿应该是眼底筛查的重点人群,临床应加强对高危因素的干预,从而降低ROP和视网膜出血的发生率。 Objective To determine the prevalence and risk factors of retinal diseases of preterm infants and full term for newborns small gestational age born (SGA) by using wide-angle digital retinal imaging system (RetCam3). Methods Clinical data of 779 preterm and SGA infants whose eyes were detected by RetCam3 between January and December 2013 before discharge were studied retrospectively. Results Among the 779 infants, there were 69 cases of retinal hemorrhage (8.9%), 10 cases (1.3%) of retinopathy of prematurity (ROP), 9 cases of retinal exudative changes, 4 cases of retinal myelinated nerve fibers, 2 cases of congenita cataract, 3 cases of retinal chromatosis, 2 cases of retinal crystalline changes and 1 case of retinoblastoma. Logistic regression analysis indicated that low birth weight and gestational age and the history of oxygen inhalation were risk factors for the development of ROP and that vaginal delivery and mechanical ventilation increased the risk of retinal hemorrhage. Conclusions Neonatal fundus diseases may be so various and harmful that early fundus screening should be carried out on high-risk infants, such as preterm and SAG infants. Preventive measures should be taken against the risk factors for fundus diseases.
出处 《中国当代儿科杂志》 CAS CSCD 北大核心 2014年第12期1197-1201,共5页 Chinese Journal of Contemporary Pediatrics
关键词 眼底筛查 早产儿视网膜病变 视网膜出血 新生儿 Fundus examination Retinopathy of prematurity Retinal hemorrhage Neonate
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