目的 调查妇幼保健院早产儿视网膜病变(ROP)的筛查及随访情况,为提高筛查和随访质量提供建议。方法 通过查阅住院病案、门诊登记及ROP管理档案,回顾性调查2019年1月1日—12月31日在某3个三级甲等妇幼保健院进行ROP筛查且符合筛查标准的3 579例早产儿的筛查、随访和干预情况。结果 ROP检出率为11.2%(400/3 579),1期为3.4%,2期为6.2%,3期及以上为1.6%。随着孕周、出生体重的降低,ROP检出率、重症ROP检出率升高。首次筛查矫正胎龄(周)为31~、32~组ROP检出率较高。ROP 1期、2期患儿干预率分别为1.6%、1.7%,低于3期的30.9%。干预方式主要采用玻璃体腔注射药物治疗(占91.3%)。全部阳性病例随访患儿的结案率为41.2%。1期、2期患儿结案率分别为51.7%、40.8%,高于3期的21.8%。结论 妇幼保健院应提升眼保健专科服务能力,加强ROP筛查,完善ROP患儿专案管理,做好筛查阳性病例的定期随访、干预、转诊工作,减少不良结局的发生。
Abstract
Objective To investigate the screening and follow-up stituation of retinopathy of prematurity (ROP) in maternal and child health care hospital, so as to provide suggestions for improving the quality of screening and follow-up. Method Screening, follow-up and intervention data of 3 579 premature infants, who were screened for ROP and met the screening criteria in triple A maternal and child health hospitals from January 1st to December 31st in 2019, were retrospectively investigated by referring to inpatient medical records, outpatient registration and ROP management files. Result The detection rate of ROP was 11.2%(400/3 579), 3.4% in stage 1, 6.2% in stage 2, and 1.6% in stage 3 and above. With the decrease of gestational age and birth weight, the detection rates of ROP and severe ROP increased. The detection rate of ROP in infants at corrected gestational age (week)of 31 ~ and 32 ~ group was higher in the first screening. The intervention rates of infants with ROP stage 1 and stage 2 were 1.6% and 1.7%, respectively, lower than 30.9% for ROP stage 3. The main intervention method was vitreous injection of drugs (91.3%). The settlement rate of all positive cases was 41.2%. The case settlement rate of infants with ROP stage 1 and stage 2 was 51.7% and 40.8%, respectively, higher than 21.8% for stage 3. Conclusion Maternal and child health care hospitals should improve the service capacity of eye care, strengthen ROP screening, improve the project management, regular follow-up, intervention of children with ROP and referral of positive cases to reduce the occurrence of adverse outcomes.
关键词
早产儿视网膜病变 /
筛查 /
随访
Key words
retinopathy of prematurity /
screening /
follow-up
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] 罗黎力, 陈大鹏, 屈艺, 等. 早产儿218例视网膜病变筛查分析[J].中华实用儿科临床杂志, 2013,28(14):1058-1060.
Luo LL,Chen DP,Qu Y, et al.Analysis of 218 cases of retinopathy of prematurity[J].Chin J Appl Clin Pediatr, 2013,28(14):1058-1060.
[2] Quinn JA, Munoz FM, Gonik B, et al. Preterm birth:Case definition & guidelines for data collection, analysis, and presentation of immunisation safety data[J]. Vaccine, 2016,34(49):6047-6056.
[3] 张巍, 尹虹, 黎晓新, 等. 早产儿视网膜病筛查管理及成本效益分析[J].中华医院管理杂志, 2006,22(9):644-646.
Zhang W,Yin H,Li XX,et al.Screening management and cost-benefit analysis of retinopathy of prematurity[J]. Chin J Hosp Admin,2006,22(9):644-646.
[4] 国家卫生和计划生育委员会. "十三五"全国眼健康规划(2016—2020年)[J]. 中华眼科杂志, 2017,53(7):484-486.
National Health Commission."13th Five-Year" national eye health plan(2016-2020)[J].Chin J Ophthalmol,2017,53(7):484-486.
[5] 黎晓新.中国早产儿视网膜病变筛查指南(2014年)[J].中华眼科杂志, 2014,50(12):933-935.
Li XX.Chinese screening guidelines for retinopathy of prematurity(2014)[J].Chin J Ophthalmol,2014,50(12):933-935.
[6] 周也群, 陈超, 陈露, 等. 中国大陆早产儿视网膜病变临床特点和眼底病变的多中心调查[J].中国循证儿科杂志, 2015,10(3):161-165.
Zhou YQ,Chen C,Chen L,et al.Multicenter survey on the clinical features and fundus lesions of retinopathy in premature infants in mainland China[J].Chin J Evid Based Pediatr, 2015,10(3):161-165.
[7] Ozcan PY. Retinopathy of prematurity among syrian refugees:Incidence and severity[J]. Middle East Afr J Ophthalmol, 2019,26(1):7-10.
[8] Arnesen L, Duran P, Silva J, et al. A multi-country, cross-sectional observational study of retinopathy of prematurity in Latin America and the Caribbean[J]. Rev Panam Salud Publica, 2016,39(6):322-329.
[9] Wu C, Lofqvist C, Smith LE, et al. Importance of early postnatal weight gain for normal retinal angiogenesis in very preterm infants:A multicenter study analyzing weight velocity deviations for the prediction of retinopathy of prematurity[J]. Arch Ophthalmol, 2012,130(8):992-999.
[10] 黎作为, 冯小志, 黎容, 等. 早产儿视网膜病变高危因素分析[J]. 国际眼科杂志, 2021,21(12):2187-2190.
Li ZW,Feng XZ,Li R,et al.High risk factors of retinopathy of prematurity[J].Int Eye Sci,2021,21(12):2187-2190.
[11] 卢敏凤,杨丽莉.早产儿视网膜病变发生的危险因素分析[J]. 中国妇幼保健, 2021,36(16):3801-3803.
Lu MF,Yang LL.Analysis of the risk factors for the development of retinopathy of prematurity[J].Maternal and Child Health Care of China,2021,36(16):3801-3803.
[12] 雷春燕, 雷博. 眼科新一代抗血管内皮生长因子药物的基础研究及临床试验进展[J].中华实验眼科杂志,2014,32(10):938-942.
Lei CY,Lei B.Basic research and clinical trial progress of the new generation of anti-vascular endothelial growth factor drugs in ophthalmology[J].Chin J Exp Ophthalmol, 2014, 32(10):938-942.
[13] 李翠洁, 叶天航, 邹毅, 等. 早产儿视网膜病变的发病机制研究进展[J].湖北民族学院学报(医学版),2018,35(1):63-66.
Li CJ,Ye TH,Zou Y,et al. Advances in the pathogenesis of retinopathy of prematurity[J].Journal of Hubei University for Nationalities(Medical Edition), 2018,35(1):63-66.
[14] 王珍, 鲁曦婷, 李之喆, 等. 苏州市立医院本部3471例新生儿中ROP患病情况分析[J]. 国际眼科杂志, 2018,18(3):572-574.
Wang Z,Lu XT,Li ZZ,et al.Prevalence of ROP in 3471 premat infants in Suzhou Municipal Hospital[J].Int Eye Sci,2018,18(3):572-574.
[15] 中华医学会儿科学分会眼科学组. 早产儿视网膜病变治疗规范专家共识[J]. 中华眼底病杂志, 2022,38(1):10-13.
Ophthalmology Group of Pediatrics Society of Chinese Medical Association.Expert consensus on the treatment of retinopathy of prematurity[J]. Chin J Ocular Fundus Dis,2022,38(1):10-13.
[16] 孙娜, 陈垂海, 杨瑰艳, 等. 三亚地区早产儿视网膜病变流行现状及其母亲相关因素分析[J]. 国际眼科杂志,2021,21(3):500-504.
Sun N,Chen CH,Yang GY,et al.Prevalence of retinopathy of prematurity in Sanya and analysis of its maternal related factors[J]. Int Eye Sci, 2021,21(3):500-504.
[17] 王宇,周晓光, 陈志均. 早产儿视网膜病治疗研究进展[J]. 中华实用儿科临床杂志,2017,32(2):146-148.
Wang Y,Zhou XG,Chen ZJ.Advances in the treatment of retinopathy of prematurity[J].Chin J Appl Clin Pediatr, 2017, 32(2):146-148.
PDF(563 KB)
