779例新生儿眼底筛查结果及新生儿眼底疾病高危因素分析

发布时间：2018-06-18 20:45

本文选题：眼底筛查 + 早产儿视网膜病变　；参考：《中国当代儿科杂志》2014年12期

【摘要】：目的应用广角数码视网膜成像系统(Ret Cam3)进行新生儿眼底筛查,了解早产儿及足月小于胎龄儿视网膜疾病的患病率及影响因素。方法回顾性分析2013年1~12月在我院新生儿病房行Ret Cam3眼底筛查的早产儿及足月小于胎龄儿的临床病例资料。结果 779例早产儿及足月小于胎龄儿接受筛查,检出有眼底病变患儿100例(12.8%),其中视网膜出血69例(8.9%)、早产儿视网膜病(ROP)10例(1.3%)、眼底渗出9例(1.2%)、视网膜有髓神经纤维4例(0.5%)、视网膜色素沉着3例(0.4%)、先天性白内障和结晶样变性各2例(0.3%)、视网膜母细胞瘤1例(0.1%)。Logistic回归分析表明低出生体重、胎龄小和有吸氧史是ROP发病的高危因素(分别OR=0.209、0.248、0.049,均P0.01);阴道分娩和有机械通气史是导致视网膜出血的高危因素(分别OR=3.196、1.731,均P0.05)。结论新生儿眼底病变多样且危害严重,早产儿及足月小于胎龄儿应该是眼底筛查的重点人群,临床应加强对高危因素的干预,从而降低ROP和视网膜出血的发生率。
[Abstract]:Objective to screen the fundus of newborns with wide angle digital retina imaging system (Ret Cam3) and to understand the prevalence and influencing factors of retinal diseases in premature infants and full-term infants with less than gestational age. Methods the clinical data of premature infants with Ret Cam3 fundus screening and full-term infants with less than gestational age were analyzed retrospectively from January to December 2013. Results 779 premature infants and full-term infants with less than gestational age were screened. 100 cases with fundus lesions were detected, including retinal hemorrhage in 69 cases (8.9%), retinopathy in 10 cases (1.3%), fundus exudation in 9 cases (1. 2%), retinal myelinated nerve fiber in 4 cases (0. 5%), retinal pigmentation in 3 cases (0. 4%), congenital cataract and crystallization. The logistic regression analysis of 1 case with retinoblastoma and 2 cases with loidomatous degeneration showed that the birth weight was low. Low gestational age and history of oxygen inhalation were the high risk factors for ROP (OR0.209, 0.248U 0.049, all P 0.01), vaginal delivery and mechanical ventilation were high risk factors for retinal hemorrhage (OR3.196 ~ 1.731, all P 0.05). Conclusion the pathological changes of fundus of newborn are various and serious. Premature infants and full-term infants with less than gestational age should be the key population of fundus screening. The intervention of high risk factors should be strengthened in clinic so as to reduce the incidence of ROP and retinal hemorrhage.
【作者单位】：贵州省妇幼保健院新生儿科;贵州省妇幼保健院眼科;
【分类号】：R774.1

【参考文献】