| 张新静,徐艳,杨倩倩,等.早产儿视网膜病变 141例自然退行与进展的影响因素分析[J].安徽医药,2023,27(7):1437-1440. |
| 早产儿视网膜病变 141例自然退行与进展的影响因素分析 |
| Analysis of influencing factors of natural degeneration and progression of retinopathy of prematurity |
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| DOI：10.3969/j.issn.1009-6469.2023.07.036 |
| 中文关键词: 早产儿视网膜病 退行 进展 病因学 无创通气 出生体质量 |
| 英文关键词: Retinopathy of prematurity Regression Progress Etiology Noninvasive ventilation Birth weight |
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| 中文摘要: |
| 目的通过分析早产儿视网膜病变(retinopathy of prematurity，ROP)自然退行和进展的影响因素，了解 ROP的发展规律，以期对 ROP病儿的临床及筛查工作有一定指导作用。方法收集 2018年 9月至 2021年 4月在徐州医科大学附属医院就诊并进行眼底筛查的病儿 472例。收集确定有眼底病变的 141例病儿的临床资料，退行组 107例，需干预治疗的进展组 34例，分析早产儿视网膜病变自然退行与进展的影响因素。结果退行组和进展组平均胎龄分别为(31.61±2.29)周、(29.76±1.82)周，经独立样本的 t检验，差异有统计学意义(P<0.05)，两组出生体质量的中位数分别为 1.58(1.25，1.82)kg、1.26(1.03，1.48)kg，无创通气时间为 8.50(6.00，18.75)d、20.00(10.75，32.25)d，两组合并支气管肺发育不良(bronchopulmonary dysplasia，BPD)的占比分别为 40.2%(43/107)，79.4%(27/34)，败血症 59.8%(64/107)、82.4%(28/34)、贫血 59.8%(64/107)，82.4%(28/34)、输血 34.6%(37/107)、 61.8%(21/34)经非参数两独立样本检验，差异有统计学意义(均 P<0.01)；多因素 logistics回归分析显示，胎龄(β=?0.32，P=0.004，OR<1)是 ROP展的独立危险因素。结论低出生体质量、胎龄小、无创通气时间长，合并支气管肺发育不良、败血症、贫血、输血的病儿 ROP进展至需干预治疗的风险较高，提示对于胎龄小、低出生体质量的早产儿加强筛查管理，对于 ROP病儿应防治 BPD、贫进，血、严格把控输血指征用氧指征；胎龄是 ROP进展的独立危险因素，应加强母孕期的检查与护理，延长孕周。 |
| 英文摘要: |
| Objective To analyze the influencing factors of natural degeneration and progression of retinopathy of prematurity(ROP), and to understand the law of development of ROP, so as to provide some guidance for the clinical and screening work of childrenwith ROP.Methods Four hundred and seventy-two children with fundus screening in The Affiliated Hospital of Xu Medical Collegefrom September, 2018 to April, 2021 were collected. The clinical data of 141 children confirmed with fundus lesions were collected, including 107 children in the degenerative group and 34 children in the progressive group requiring intervention, to analyze the influencing factors of natural degeneration and progression of retinopathy of prematurity.Results The mean gestational age of the regressivegroup and the progressive group was (31.61±2.29) weeks and (29.76±1.82) weeks, respectively. The t test of independent samples showed statistically significant differences (P<0.05). The median birth weight of the two groups were [1.58 (1.25, 1.82)] kg and [1.26 (1.03, 1.48)]kg, non-invasive ventilation time was [8.50 (6.00, 18.75) ]d and [20.00 (10.75, 32.25)]d. The ratio of the two combinationswith bronchopulmonary dysplasia was 40.2% (43/107) and 79.4% (27/34), sepsis was 59.8% (64/107), 82.4% (28/34), anemia was59.8% (64/107), 82.4% (28/34), blood transfusion was 34.6% (37/107), 61.8% (21/34), the difference was statistically significant aftertwo independent samples test (all P<0.01). Multivariate logistic regression analysis showed that gestational age (β=?0.32, P=0.004,OR< 1) was an independent risk factor for ROP progression.Conclusion Children with low birth weight, small gestational age, long duration of noninvasive ventilation, the combination of bronchial pulmonary dysplasia, sepsis, anemia, blood transfusion have a higher riskof ROP progression to intervention therapy, suggesting that preterm infants with small gestational age and low birth weight should bestrengthen the screening and management, ROP children should be prevent BPD and anemia, and strictly control the blood transfusionindication of oxygen indications; gestational age is an independent risk factor for the progression of ROP, so maternal examination andnursing during pregnancy should be strengthened to prolong the gestational age. |
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