早产儿及低体质量儿视网膜病变发病率及相关危险因素研究分析

摘要

Objective To investigate the incidence and risk factors of retinopathy in premature and low birth weight infants.Methods One hundred and twelve premature infants and low birth weight infants were selected from December 2013 to June 2016.We used the lens (28D) and indirect fundus lens combined with scleral compression device to examine the fundus of the study.We calculated retinopathy detection, and analyzed the correlation between the rate of neonatal body weight, gestational age and gender and pathogenesis of retinopathy, and other factors (apnea, premature rupture of membranes, blood transfusion, mechanical ventilation, multiple births, splits the palace production) and retinopathy rate correlation and retinopathy independent risk factors.Results Among the 112 cases of premature and low birth weight infants, there were 12 retinal diseases, and the incidence rate was 10.71% (12/112).There was significant difference in the incidence of neonatal body mass than 2 000 g, 1 500-2 000 g, and less than 1 500 g retinopathy (P< 0.05), and the smaller the body mass, the higher the incidence of retinopathy.Gestational age greater than 34 weeks, 30-34 weeks, less than or equal to 30 weeks incidence had significant differences between the groups (P<0.05), and the smaller the gestational age, the higher the incidence of retinopathy.The incidence of male and female had no significant difference(P>0.05).There were close correlation of the respiratory pause, mechanical ventilation with the incidence of retinopathy, and the differences were significant (P<0.05).There were no correlation of the incidence of premature rupture of membranes, blood transfusion, multiple births, cesarean section with the incidence of retinopathy(P>0.05).The Logistic multiple regression analysis showed that the independent risk factors of retinopathy of premature and low birth weight infants included the apnea, mechanical ventilation, body weight, gestational age.Conclusions Apnea, mechanical ventilation, body weight, gestational age are independent risk factors for premature and low body weight infant retinopathy, clinicians should timely make intervention measures according to whether with such risk factors, reduce the incidence of retinopathy, and improve the prognosis.%目的 探讨早产儿及低体质量儿视网膜病变发病率及相关危险因素.方法 选取2013年12月至2016年6月符合研究选取标准的112例早产儿及低体质量儿,选用透镜(屈光度:28D)及间接眼底镜结合巩膜压迫器对研究对象眼底进行检查.统计视网膜病变检出情况,并分析新生儿体质量、胎龄及性别与视网膜病变发病率相关性、其他因素(呼吸暂停、胎膜早破、输血、机械通气、多胎、剖宫产)与视网膜病变发病率相关性及视网膜病变独立危险因素.结果 本组112例早产儿及低体质量儿中,发生视网膜病变者共12例,视网膜发病率为10.71%(12/112);新生儿体质量>2 000 g、1 500~2 000 g、<1 500 g视网膜病变发病率组间比较差异有统计学意义(P<0.05),且体质量越小,视网膜病变发病率越高;胎龄>34周、30~34周、≤30周发病率组间比较差异有统计学意义(P<0.05),且胎龄越小,视网膜病变发病率越高;男性发病率与女性发病率比较差异未见统计学意义(P>0.05);呼吸暂停、机械通气与视网膜病变发病率具有密切相关性,差异有统计学意义(P<0.05);尚不能认为胎膜早破、输血、多胎、剖宫产与视网膜病变发病率相关(P>0.05);经Logistic多因素回归分析可知,早产儿及低体质量儿视网膜病变独立危险因素包括呼吸暂停、机械通气、体质量、胎龄.结论 呼吸暂停、机械通气、体质量、胎龄均是早产儿及低体质量儿视网膜病变发病独立危险因素,临床应根据早产儿或低体质量儿是否具备此类危险因素而及时制定干预措施,降低视网膜病变发病率,改善预后.