探讨不同胎龄早产儿引起视网膜病变的因素

Exploring the Factors Causing Retinopathy in Premature Infants of Different Gestational Ages

摘要: 目的：通过单中心回顾性研究不同胎龄早产儿视网膜病变(retinopathy of prematurity, ROP)的发生率，探讨母乳喂养对其影响，为ROP的防治提供临床指导。方法：选取2017年1月至2021年1月山东省临沂市人民医院新生儿重症监护室(neonatal intensive care unit, NICU)接受住院监护及眼底筛查的早产儿共计240例作为研究对象，收集患儿的性别、胎龄、出生体重、新生儿疾病、住院及治疗情况、1 min Apgar评分情况、分娩方式、孕母妊娠期合并症、母乳喂养等，根据筛查结果通过ROP发生率，录入SPSS25.0统计学软件，进行质量控制，采用单因素及Logistic多因素回归分析，分析ROP发生的影响因素。结果：240例早产儿中共筛查出胎龄 < 28周、28~32周、>32周三组ROP发生率分别为37.78%、22.22%、9.52%；出生体重(OR = 5.241)、新生儿呼吸窘迫综合征(OR = 1.952)、孕母妊娠期贫血(OR = 5.224)是不同胎龄ROP发生的高危因素(P < 0.05)，母乳喂养(OR = 0.632)是不同胎龄ROP发生的保护性因素(P < 0.05)。结论：1) 胎龄越小，ROP发生率越高。2) 影响ROP发生的高危因素较多，包括出生体重、新生儿呼吸窘迫综合征、孕母妊娠期贫血。3) 母乳喂养是ROP发生的保护性因素。

Abstract: Objective: Through a single center retrospective study on the incidence of Retinopathy of prema-turity (ROP) in different gestational ages, to explore the impact of breast feeding on it, and to pro-vide clinical guidance for the prevention and treatment of ROP. Methods: From January 2017 to January 2021, a total of 240 preterm infants in the neonatal intensive care unit (NICU) of Linyi Peo-ple’s Hospital in Shandong Province who received in-patient care and fundus screening were se-lected as the study subjects, and their gender, gestational age, birth weight, neonatal diseases, hos-pitalization and treatment, 1-minute Apgar score, delivery mode, maternal complications, breast-feeding, etc. were collected. Based on the screening results, the incidence of ROP was recorded into SPSS 25.0 statistical software for quality control. Single factor and logistic multiple factor regression analysis were used to analyze the influencing factors of ROP occurrence. Result: A total of 1.240 premature infants were screened with ROP incidence rates of 37.78%, 22.22%, and 9.52% in the gestational age < 28 weeks, 28~32 weeks, and >32 weeks groups, respectively; Birth weight (OR = 5.241), Infant respiratory distress syndrome (OR = 1.952), maternal anemia during pregnancy (OR = 5.224), were high risk factors for ROP at different gestational ages (P < 0.05). Breastfeeding (OR = 0.632) was a protective factor for ROP at different gestational ages (P < 0.05). Conclusion: 1) The younger the gestational age, the higher the incidence of ROP. 2) There are many high risk factors affecting the occurrence of ROP, including birth weight, Infant respiratory distress syndrome, and oxygen therapy mode. 3) Breastfeeding is a protective factor for the occurrence of ROP.