139例出生体重≤1500g早产儿视网膜病变筛查分析

摘要

目的 了解低出生体重(≤1500g)早产儿视网膜病变(ROP)发病相关情况,并分析其影响因素及预后.方法 2012年10月至2014年12月收治的出生体重≤1500g的139例早产儿进行ROP筛查.其中,男婴86例,女婴53例.孕龄26-37周,平均(31.17±2.51)周.出生体重为698-1500g,平均(1296.5±218.1)g,根据结果分为正常组和ROP组,并对两组间性别、出生体重、出生孕龄、分娩方式、吸氧情况、呼吸窘迫综合症、缺血缺氧性脑病、贫血等因素进行分析.结果 139例患儿中有57例发生不同程度的ROP,占41.0%.其中,1期病变9例,约占本组的15.78%;2期病变18例,占31.57%;3期病变29例,约占50.87%;4期病变1例,约占1.75%;无5期病变患儿.接受激光光凝治疗17只例,手术治疗1例.ROP组的平均出生体重(1237.2±182.6)g低于正常组患儿的平均出生体重(1354.1±169.4)g,ROP组的平均孕龄(29.67±2.09)周低于正常组患儿平均孕龄(32.12±2.67)周,均有显著性差异(P均<0.05).早产儿孕龄越小、平均出生体重越低ROP发生率越高.各单因素和ROP关系进行卡方检验分析,结果显示出生体重≤1250g、孕龄≤30周、吸氧>5d、缺血缺氧性脑病与ROP的发生有相关性(P均<0.05),性别、分娩方式、呼吸窘迫综合征、贫血与ROP的发生无相关性(P均>0.05).结论 出生体重≤1500g早产儿ROP的发生率为41.0%;低孕龄、低出生体重、氧疗和缺血缺氧性脑病是影响ROP发生和发展的高危因素.%Objective To estimate the incidence of retinopathy of prematurity (ROP)in preterm infants with a birth weight of 1500g or less,to identify the related risk factors and to assess the outcome of these cases. Methods From October 2012 to De-cember 2014,A ROP screening survey was performed in a total of 139 preterm infants (86 males and 53 females) with a birth weight of 1500g or less. Their gestational ages were from 26 to 37 weeks,with a mean of (31.17±2.51) weeks,Their birth weights were from 698 to 1500 grams,with a mean of (1296.5±218.1g). According to the screening results,all cases were divided into nor-mal group and ROP group. We also assessed the risk factors for ROP:the sex,gestational age,birth weight,delivery mode,oxygen therapy,respiratory distress syndrome,hypoxic ischemic encephalopathy,anemia using statistics analysis. Results In 139 infants, 57 infants (41.0%) developed ROP. 9 (15.78%) cases stage 1,18 (31.57%) cases stage 2,and 29 (50.87%) cases stage 3,1(1. 75%) cases stage 4. None of the studied infants presented ROP at stage 5. The seventeen severe cases underwent photocoagulation therapy and one case underwent vitrectomy therapy. The mean birth weight (1237.2±182.6g)and gestational age (29.67±2.09w) of ROP group were significantly lower than those (1354.1 ±169.4g and 32.12 ±2.67w) of normal group (all P<0.05). The infants with smaller gestational ages and lower birth weights had higher incidences of ROP. Chi-square test showed that there was a significant relationship between the occurrence of ROP and birth weight (≤1250g),gestational age (≤30w),oxygen therapy (>5d),hypoxic is-chemic encephalopathy (all P<0.05). However,an insignificant relationship was found between the ROP and sex,delivery mode, respiratory distress syndrome,anemia (all P>0.05). Conclusion The prevalence of ROP in the infants with a birth weight of 1500g or less was 41.0%,low gestational age,low birth weight,oxygen therapy and hypoxic ischemic encephalopathy were the important risk factors for the occurrence and progression of ROP.