目的 了解胎龄≤34周早产儿视网膜病(ROP)的发病情况及造成ROP的相关危险因素,为临床早期筛查高危早产儿提供依据。方法 回顾性分析2015年6月—2020年6月在新疆医科大学第一附属医院NICU住院的胎龄≤34周早产儿的相关病例资料,按照眼底筛查结果分为ROP组和无ROP组,收集相关数据,分析早产儿ROP的相关危险因素。结果 共纳入1 738例胎龄≤34周早产儿,其中ROP组292例(占16.8%),无ROP组1 446例;经过Logistic回归分析:新生儿支气管肺发育不全(BPD)(OR=3.379,95%CI:1.835~6.221)、贫血(OR=7.388,95%CI:4.262~12.806),接受输血治疗(OR=2.129,95%CI:1.278~3.547)、用氧时长＞7d(OR=3.429,95%CI:2.309~5.094)、用氧浓度＞40%(OR=2.541,95%CI:1.540~4.193)是ROP发生的独立危险因素。167只眼(103例患儿)接受了治疗,雷珠单抗注射液眼内注射108只,眼底激光治疗35只,雷珠单抗注射液眼内注射联合眼底激光治疗24只,在后期随访中均转归良好。结论 合并贫血、BPD、接受输血治疗、吸氧时间＞7d、用氧浓度＞40%的早产儿是发生ROP的高风险人群。对此类人群需规范进行眼底筛查,及时行治疗措施,可降低早产儿视力障碍的风险。
Abstract
Objective To understand the prevalence of retinopathy (ROP) in preterm infants with gestational age ≤34 weeks in the First Affiliated Hospital of Xinjiang Medical University, and to analyze the associated risk factors, so as to provide a basis for early screening of high-risk premature infants. Methods A retrospective analysis was conducted on the relevant case data of hospitalized premature infants with gestational age ≤34 weeks in neonatal intensive care unit (NICU) of the First Affiliated Hospital of Xinjiang Medical University from June 2015 to June 2020. Infants were divided into ROP group and non-ROP group based on the results of fundus screening. Relevant data were collected to analyze the relevant risk factors for ROP in premature infants. Result A total of 1 738 premature infants with gestational age ≤34 weeks were included, with 292 cases (16.8%) in ROP group and 1 446 cases in non-ROP group. Logistic regression analysis revealed that bronchopulmonary dysplasia(BPD) (OR=3.379, 95%CI:1.835 - 6.221), anemia (OR=7.388, 95%CI: 4.262 - 12.806), receiving blood transfusion treatment (OR=2.129, 95%CI: 1.278 - 3.547), oxygen requirement time >7 days (OR=3.429, 95%CI: 2.309 - 5.094), and the fraction of inspired oxygen greater than 40% (OR=2.541, 95%CI: 1.540 - 4.193) were independent risk factors for the occurrence of ROP. Among these patients, 167 eyes (103 patients) received treatment of ROP, including 108 eyes treated with intraocular injection of Rizumab, 35 eyes treated with fundus laser, and 24 eyes treated with combination of both. All patients had acceptable outcomes during the follow-up. Conclusions Premature infants with anemia, BPD, receiving blood transfusion treatment, oxygen requirement time >7 days, and the fraction of inspired oxygen >40% are at high risk of developing ROP. Standardized fundus screening and timely treatment measures are essential to reduce the risk of visual impairment in premature infants.
关键词
早产儿 /
早产儿视网膜病 /
贫血 /
支气管肺发育不良
Key words
premature infants /
retinopathy of prematurity /
anemia /
bronchopulmonary
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