早产儿视网膜病筛查阳性率的变化趋势及相关因素分析

发布时间：2019-02-22 11:00

【摘要】：目的: 探讨早产儿视网膜病(retinopathy of prematurity,ROP)筛查阳性率的变化趋势及相关影响因素,并提出干预措施。方法: 将2005年1月1日至2008年12月31日在我院新生儿科住院,出生体重2000g的早产儿和低体重儿1116例纳入研究。收集病史者对符合ROP筛查入选条件的研究对象,按住院时间顺序进行编号,填写ROP筛查临床记录表,记录研究对象住院过程及出院ROP随访的临床资料。ROP眼底检查由专业眼科医生操作,根据国际ROP分类法分期分区诊断ROP病变。研究资料采用SAS8.1和SPSS11.5软件统计,调查我院2005-2008年ROP的筛查阳性率、筛查比例、随访比例及不同出生体重和胎龄构成比例、危重病例构成比例的变化趋势,分析ROP筛查阳性率的变化趋势及相关影响因素。计数资料中各研究指标的变化趋势使用卡方检验中的Cochran-Armitage Trend Test,各因素与ROP筛查阳性率的相关性用Correlations Spearman。结果: 1.2005-2008年我院ROP筛查阳性率分别为5.8%、8.5%、13.2%、14.5%,呈逐年上升趋势;阈值以上ROP发生比例分别为1.9%、1.9%、2.0%、2.3%,无统计学意义。 2.四年中出生体重1500g研究对象ROP筛查阳性率为19.1%,1500g-1999g ROP筛查阳性率为5.8%,两者相关分析有显著统计学意义(R=0.20, P0.01);出生胎龄32w研究对象ROP筛查阳性率18.3%,出生胎龄≥32w ROP筛查阳性率4.9%,两者相关分析有显著统计学意义(R=0.20, P0.01);危重病例ROP筛查阳性率15.4%;非危重病例ROP筛查阳性率5.6%,两者相关分析有显著统计学意义(R=0.14,P0.01)。 3.2005-2008年筛查比例分别为56.0%、81.3%、93.1%、93.7%;随访比例分别为44.8%、54.4%、62.4%、75.3%;完成随访病例中出生体重1500g构成比例分别为40.4%、42.5%、45.7%、52.1%,出生胎龄32w构成比例分别为42.3%、50.0%、54.3%、57.3%,危重病例所占比例分别为51.9%、60.4%、67.5%、71.4%;经Cochran-Armitage Trend Test分析,均呈逐年上升趋势,经Correlations Spearman分析,均与ROP筛查阳性率的变化趋势相关。结论: 1.本调查显示2005-2008年ROP筛查阳性率从5.8%上升至14.5%,呈逐年上升趋势,但阈值以上ROP无明显增加。 2.极低体重儿和小胎龄儿比例增加、危重病例比例增加及规范管理是影响ROP筛查阳性率变化趋势的相关因素。 3.建议基层医院及时将危重儿、极低出生体重儿和小胎龄儿转运到具备氧疗检测条件和抢救技术的医院,更加注重规范用氧,强调此类患者的综合管理,是降低ROP发生率和致盲率的有效干预措施。
[Abstract]:Purpose: The change trend of the positive rate of retinitis of prematurity of prematurity (ROP) and the related factors were discussed, and the intervention measures were put forward. Shi. Method: From January 1, 2005 to December 31, 2008, the newborn department of our hospital was hospitalized with a weight of 2000g of premature and low-weight infants. Patients were included in the study. The subjects who had a medical history of the inclusion criteria for the ROP screening were collected, numbered in the course of the hospital stay, the ROP screening clinical record, the study subject's hospitalization, and the discharge of the ROP follow-up. Clinical data. The ROP fundus examination is operated by a professional ophthalmologist and is diagnosed according to the classification of the international ROP classification. The positive rate of ROP in our hospital from 2005 to 2008, the proportion of screening, the proportion of follow-up, the proportion of different birth weight and the gestational age and the proportion of the critical cases were investigated by using the software of SAS8.1 and SPSS11.5. The change trend of the positive rate of ROP was analyzed and the phase of the positive rate of ROP was analyzed. Cross-correlation factors. The trend of each of the study indicators in the count data is using the Cochran-Armitage Trend Test in the card-side test, and the correlation between the factors and the positive rate of ROP screening is Correlations Spe. arm Results: 1. The positive rate of ROP in our hospital from 2005 to 2008 was 5.8%, 8.5%, 1.3. 2% and 14.5%, respectively. The rate of ROP in the above threshold was 1. 9%, 1. 9%, 2.0%, 2. The positive rate of ROP was 19. 1%, 1500g-1999g ROP, and the positive rate of ROP was 52.8%. The positive rate of ROP was 18. 3%, and the birth birth weight was 32w R. The positive rate of OP screening was 4.9%, and the correlation between them was statistically significant (R = 0.20, P0.01); the positive rate of ROP in critical cases was 15.4%; the positive rate of ROP in non-critical cases was 55.6%, and the correlation between them was statistically significant (R = The proportion of birth weight in the follow-up cases was 40.4%, 42.5%, 45.7%, 52.1%, and the birth weight of 32w in the follow-up cases, respectively. The proportion of 42. 3%, 50. 0%, 54. 3%, 57. 3% and critical cases was 55.9%, 60.4%, 67.5%, 71.4%, respectively. The analysis of Cochran-Armitage Trend Test showed a trend of year-by-year. P screening Conclusion: 1. The positive rate of ROP was increased from 5.8% to 14.5% in 2005-2008, and the positive rate of ROP in 2005-2008 increased from 5.8% to 14.5%. There was no significant increase in the number of ROP above the threshold, but the proportion of critical cases increased, the proportion of critical cases increased, and the regulation and management were the same. The related factors that affect the change trend of the positive rate of ROP screening are discussed. 3. It is suggested that the basic hospital should transfer critically ill, extremely low birth weight and small child to the hospital with oxygen therapy detection condition and rescue technique, and pay more attention to the regulation of oxygen, and emphasize the comprehensive management of such patients.
【学位授予单位】：广州医学院
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R774.1

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