摘要
目的探讨急进性早产儿视网膜病(retinopathy of prematurity,ROP)与普通型ROP临床特征及发生急进性ROP的影响因素。方法选取2014年1月至2018年12月于深圳市人民医院新生儿病房住院的ROP患儿进行回顾性分析,根据患儿是否达到急进性ROP诊断标准分别纳入急进性ROP组和普通型ROP组。收集患儿的临床资料、治疗情况及母亲围生期资料,应用SPSS 18.0统计软件比较两组差异。结果127例ROP患儿中107例为普通型ROP,20例为急进性ROP。普通型ROP组与急进性ROP组胎龄、出生体重比较差异无统计学意义(P>0.05),两组胎龄<32周早产儿分别占91.6%(98/107)和95.0%(19/20),出生体重<1500 g分别占84.1%(90/107)和90.0%(18/20)。普通型ROP组输血≥2次者占53.3%(57/107),急进性ROP组占85.0%(17/20),差异有统计学意义(P<0.05)。普通型ROP组81.3%(87/107)使用机械通气,69.2%(74/107)通气时间≤7 d;急进性ROP组全部使用机械通气,65.0%(13/20)通气时间>7 d。急进性ROP组较普通型ROP组机械通气时间明显延长(P<0.05)。普通型ROP组部分需激光光凝治疗,预后均较好;急进性ROP组治疗多采用玻璃体腔注药,部分需联用激光光凝,大部分预后较好。结论急进性ROP与普通型ROP患儿一般临床特征无明显差异,但输血、机械通气时间延长与急进性ROP发生相关。
Objective To study the differences of clinical features between aggressive posterior retinopathy of prematurity(APR0P)and general retinopathy of prematurity(GROP)and to find the risk factors of APROP.Method From January 2014 to December 2018,newborns with retinopathy of prematurity(ROP)hospitalized in our hospital were retrospectively studied.According to the diagnosis criteria of APROP,the newborns were assigned into GROP group and APROP group.Their clinical data,treatment and perinatal data were collected.SPSS 18.0 was used to compare the differences between the two groups.Result A total of 127 newborns were included in the study,107 in the GROP group and 20 in the APROP group.91.6%(98/107)infants with gestational age(GA)<32 w were in the GROP group and 95.0%(19/20)in the APROP group.84.1%(90/107)infants with birth weight(BW)<1500 g were in the GROP group and 90.0%(18/20)in the APROP group.No significant differences existed of GA and BW between the two groups.53.3%(57/107)infants in the GROP group received≥2 times of blood transfusion,significantly lower than 85.0%(17/20)in the APROP group(P<0.05).Mechanical ventilation(MV)was used in 81.3%(87/107)infants in the GROP group with most duration less than 7 days(69.2%,74/107).MV was used in all infants in the APROP group with most duration longer than 7 days(65.0%,13/20).The APROP group had significantly longer MV duration than the GROP group(P<0.05).Some of the GROP group received laser photocoagulation therapy and all had good prognosis.Most of the APROP group received intravitreal injection and some of them combined with laser photocoagulation.The majority of them had favorable prognosis.Conclusion The APROP group and the GROP group have similar general clinical characteristics.Increased blood transfusion and elongated MV duration may be risk factors for APROP.
作者
郑慧芬
丁璐
吴本清
Zheng Huifen;Ding Lu;Wu Benqing(Department of Pediatrics,Shenzhen People's Hospital Shenzhen 518020,China;Department of Neonatology,Shenzhen Hospital of University of Chinese Academy of Sciences,Shenzhen 518020,China)
关键词
视网膜病
早产儿
急进性早产儿视网膜病
普通型早产儿视网膜病
Retinopathy,premature infant
Aggressive posterior retinopathy of prematurity
General retinopathy of prematurity
