目的 探讨使用空气混合器预防早产儿视网膜病(retinopathy of prematurity,ROP)发生的效果和可行性。 方法 观察组117例早产儿,采用空氧混合器置中间,它的一端接中心供氧和空气气源,另一端接头、面罩、暖箱或改良鼻导管,并在供氧末端予氧浓度测定仪动态监测。在生后4~6周或矫正胎龄32周行眼底检查,1~2周酌情复查,并追踪随访3~6个月,与对照组95例未施行空氧混合仪供氧的早产儿比较,观察他们发生ROP的例数和程度。 结果 212例早产儿中共检出ROP 8例,男5例,女3例,发生率3.77%,其中观察组发生ROP 2例(1.71%),对照组发生ROP 6例(6.32%),两组ROP发生率差异有统计学意义(P<0.01)。患有呼吸暂停、窒息、肺透明膜病、反复低氧血症、败血症、肺出血、胎龄小、吸氧时间长及应用PS、机械通气的患儿ROP发生率均高于无此高危因素的患儿,其差异有统计学意义(P<0.01)。 结论 使用空氧混合器规范氧疗可降低ROP发生率,空氧混合器简便、价廉,适合基层医院应用,ROP发生与小胎龄、低出生体重、长时间和高浓度吸氧、反复低氧血症、严重感染等多种高危因素有关。

Objective To explore the effect and feasibility on air oxygen mixing instrument by preventings retinopathy of prematurity(ROP) in preterm infantsmeasures. Method A total of 117 preterm infants of test group were used air oxygen mixing instrument in oxygen inhalation,undergone indirect funduscopic examinations two weeks after birth,and then they were followed-up,the outcome were compared with control group(n=95) of no intervention. Results A total of 212 cases of premature infants,8 cases occurred in ROP,accounted for 3.77%,5 males and 3 females.3 cases were ROP Ⅰstage,4 cases were ROP Ⅱ stage,and 2 case were ROP Ⅲ stage.Among the 8 cases,2 cases in test group and 6 cases in control group,the incidence of ROP was obviously different between two groups(P<0.01).High risk factor analysis showed that neonatal asphyxia,apnea,hyaline membrane disease,severe infection,pneumorrhagia,gestation age,birth weight,concentration of oxygen inhalation,time of oxygen inhalation and mechanical ventilation were significantly related to ROP(P<0.01). Conclusion Using air oxygen mixing instrument in oxygen inhalation can depress the incidence of ROP in preterm infants,the development of ROP is higher in the preterm infants with more complications,higher oxygen concentration and longer mechanical ventilation time.