摘要
目的分析不同胎龄新生儿早产儿视网膜病变(ROP)筛查和治疗的结果。方法横断面研究。收集2020年5月~2022年4月在徐州市第一人民医院采用广角数码视网膜成像系统和双目间接检眼镜进行筛查的1 589例新生儿纳入研究, 按胎龄分为6组, 比较不同胎龄组ROP的发生情况;需治疗的ROP患儿行玻璃体内注射雷珠单抗(IVR)或激光光凝术, 比较不同胎龄组ROP的治疗情况。结果本研究新生儿中检出102例(6.42%, 102/1 589)患有不同程度ROP, 需要手术治疗的ROP 45例(2.83%, 45/1 589), 其中41例接受了IVR治疗, 4例接受了激光光凝治疗。不同胎龄组间ROP发病率(χ^(2)=300.30, P<0.001)和需治疗ROP比例(χ^(2)=278.50, P<0.001)差异有统计学意义。不同胎龄组间需治疗ROP患儿男/女、多/单胎、I/II区病变、IVR/激光治疗比例及出生至手术时间差异均无统计学意义(均P>0.05);不同胎龄组首次治疗时矫正胎龄差异有统计学意义(χ^(2)=13.52, P=0.019)。胎龄<32周患儿首次治疗时矫正胎龄(36.55±2.51)周, 胎龄≥32周患儿为(40.48±3.38)周。ROP复活再治疗6例, 首次IVR术后24周未见药物相关性并发症。结论胎龄越小, ROP发病率和需治疗的患儿比例越高, 且首次治疗时矫正胎龄越小。
Objective To analyze the screening and treatment for retinopathy of prematurity(ROP)in newborns with different gestational age.Methods This was a cross-sectional study.A total of 1589 infants were screened from May 2020 to Apr.2022 by RetCam III and binocular ophthalmoscope.All cases were divided into 6 groups based on different gestational age.The incidence of ROP and on-demand treatment of ROP in different gestational age groups were compared.The cases requiring treatment for ROP received intravitreal injection of ranibizumab(IVR)or laser photocoagulation.The treatment conditions in different gestational age groups were compared.Results Among 1589 infants,102 cases(6.42%,102/1589)had different stages of ROP.A total of 45 cases(2.83%,45/1589)needed treatment,among them 41 cases received IVR and 4 cases received laser coagulation.There were no statistically significant differences in the incidences of ROP(χ^(2)=300.30,P<0.001)and on-demand treatment of ROP(χ^(2)=278.50,P<0.001)between different gestational age groups.The proportion of male/female,multiple/single,zone I/II,IVR/laser coagulation and the postnatal time at baseline treatment had no statistically significant difference(all P>0.05),but there was statistically significant difference in the corrected gestational age at the first treatment between different gestational age groups of on-demand treatment of ROP(χ^(2)=13.52,P=0.019).At the first treatment,the corrected gestational ages were(36.55±2.51)weeks for infants with gestational age<32 weeks and(40.48±3.38)weeks for those with gestational age≥32 weeks.Retreatments were performed in 6 patients who had ROP reactivation.No complications related to ranibizumab were found in infants after IVR within 24 weeks.Conclusion The smaller the gestational age,the higher the incidence of ROP and on-demand treatment for ROP,and the smaller the corrected gestational age at the first treatment.
作者
刘亚鲁
管莉娜
黎严莲
王梅
孙艳梅
蔡鹂鸣
邹泉
李甦雁
Liu Yalu;Guan Lina;Li Yanlian;Wang Mei;Sun Yanmei;Cai Liming;Zou Quan;Li Suyan(Department of Ophthalmology,the Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University,Xuzhou First People’s Hospital,Institute of Eye Disease Prevention and Treatment of Xuzhou,Xuzhou 221002,China)
出处
《中华眼外伤职业眼病杂志》
2023年第2期94-98,共5页
Chinese Journal of Ocular Trauma and Occupational Eye Disease
基金
徐州市卫生健康委科技项目(XWKYSL20210257)
徐州市第一人民医院"青苗工程"(QMHB2021018)。
关键词
婴儿
早产
早产儿
视网膜病
流行病学
普查
Infant,premature
Retinopathy of prematurity
Epidemiology
Mass screening
