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目的评价早产儿视网膜病(ROP)临床特点及远期治疗效果。方法回顾性分析2004-01-01—2009-07-31复旦大学附属儿科医院新生儿科收治的107例ROP患儿临床资料、ROP分期、治疗情况及远期预后。结果 1期和2期ROP共64例,6例2期病变达Ⅰ型阈值前病变而采用激光治疗,其他均未进行特殊治疗;除失访和死亡病例外,所有随访病例ROP病变均消退,远期视力不受影响。3期病变15例,其中14例达阈值病变者给予激光或冷凝治疗,1例未达阈值病变者不需要治疗。有完整随访资料的11例患儿中3例术后视力严重受损,仅存在光感,其余8例视力正常。4期和5期ROP共28例,随访的18例患儿中,仅1例手术后保存了正常视力(占5.6%),失明者达12例(占66.7%),其余5例虽保存视力,但视力极差,仅存光感(占27.7%)。结论 ROP防治关键在于预防ROP发生,当出现ROP早期病变时应严格筛查和及时干预,一旦疾病进入晚期,出现视网膜脱离时再治疗,则治疗效果不佳。
Objective To evaluate the clinical features and long-term therapeutic effects of retinopathy of prematurity (ROP). Methods Retrospective analysis of clinical data, ROP staging, treatment and long - term prognosis of 107 cases of ROP admitted to Department of Neonatology, Fudan University Pediatric Hospital from 2004-01-01-2009-07-31. Results There were 64 cases of ROP in stage 1 and 2, and 6 cases of stage 2 disease were treated with laser before type Ⅰ thrombosis. No other treatment was performed on all cases. ROP lesions were subsided in all cases except the cases of loss of follow-up and death, Long-term vision is not affected. Three stages of disease in 15 cases, of which 14 cases of threshold lesions were given laser or condensation treatment, 1 case of less than the threshold of disease without treatment. Among the 11 children with complete follow-up data, 3 had serious visual impairment after operation, only light perception existed, and the remaining 8 had normal vision. Stage 4 and stage 5 ROP were 28 cases. Of the 18 cases followed up, only 1 case had normal visual acuity (5.6%) after surgery, 12 cases (66.7%) had blindness, and the remaining 5 cases had preserved visual acuity , But poor visual acuity, only the light perception (27.7%). Conclusions The key of prevention and treatment of ROP is prevention of ROP. When early lesions of ROP occur, they should be screened and promptly interfered. Once the disease enters advanced stage and retreatment after retinal detachment occurs, the curative effect is not good.