摘要
目的分析阈值期早产儿视网膜病变（ROP）的临床特征，并评价眼底激光凝固术的治疗效果。方法对549例符合筛查指征的早产儿进行眼底筛查，共发现ROP患儿108例，1、2期及3期非阈值病变ROP患儿74例，阈值病变ROP患儿34例；对阈值病变ROP患儿进行眼底激光凝固术治疗，术后眼科医师定期检查眼底。结果ROP总发生率为8．6％（108／1255），占筛查数的19．7％（108／549），阂值病变ROP占早产儿的2．7％（34／1255），占筛查数的6．2％（34／549）。1、2期及3期非阈值病变ROP患儿的胎龄、出生体重均较阈值病变ROP患儿大，而吸氧时间较短，差异均有统计学意义（P〈0．05）；74例1、2期及3期非阈值病变患儿未治疗，定期随访至眼底恢复正常。34例阈值病变ROP患儿的68只眼接受眼底激光凝固术治疗，成功率为94．1％，2例（4只眼）治疗后发生部分视网膜脱离，经玻璃体视网膜手术后病变控制。结论早产儿胎龄越小、出生体重越低、吸氧时间越长，ROP阈值病变的发生率越高；预防的关键是早期筛查；眼底激光凝固术治疗是阻止阈值期ROP发展的有效方法；术后处理重点是呼吸管理。
Objective To investigate the clinical characteristics of threshold retinopathy of prematurity （ROP）and evaluate the efficacy of retinal photocoagulation. Methods Five hundred and forty-nine premature infants were screened for ROP with binocular indirect ophthalmoscope, and 108 infants were diagnosed as ROP. Seventy-four patients with stage 1 and stage 2 prethreshold ROP were divided into group A and 34 patients with threshold ROP were divided into group B. The clinical characteristics of the premature infants such as gestational age, birth weight and duration oxygen supplementation were analyzed to evaluate their correlation with the development of ROP. The infants with threshold ROP were treated with retinal photocoagulation and followed up. Results The incidence of ROP was 19.7% （108/549）, and that of the threshold ROP was 6.2%（34/549）. The birth weight and gestational age of group A were lower than those of group B, however, the duration of oxygen supplementation in group A was shorter （P〈 0.05）. Seventy-four patients in group A recovered spontaneously without any treatment. The recovery rate of photocoagulation in patients with threshold ROP was 94.1% （64/68 eyes）. Only 2 patients （4 eyes） with partial retina detachment after photocoagulation were treated with vitreous retina surgery. Conclusions Premature infants with lower birth weight, smaller gestational age and longer duration of oxygen supplementation have more chance of developing ROP. Early screening is the key to prevent threshold ROP. Photocoagulation is the effective way to control threshold ROP, and respiratory management is very important after operation.
出处
《中华围产医学杂志》
CAS
2009年第4期285-288,共4页
Chinese Journal of Perinatal Medicine
基金
2004年广东省深圳市重点科技项目（400405044）
关键词
视网膜病
早产儿
激光凝固术
Retinopathy of prematurity
Laser coagulation
