發(fā)布時間：2019-02-22 11:00

【摘要】：目的: 探討早產(chǎn)兒視網(wǎng)膜病(retinopathy of prematurity,ROP)篩查陽性率的變化趨勢及相關(guān)影響因素,并提出干預(yù)措施。 方法: 將2005年1月1日至2008年12月31日在我院新生兒科住院,出生體重2000g的早產(chǎn)兒和低體重兒1116例納入研究。收集病史者對符合ROP篩查入選條件的研究對象,按住院時間順序進(jìn)行編號,填寫ROP篩查臨床記錄表,記錄研究對象住院過程及出院ROP隨訪的臨床資料。ROP眼底檢查由專業(yè)眼科醫(yī)生操作,根據(jù)國際ROP分類法分期分區(qū)診斷ROP病變。研究資料采用SAS8.1和SPSS11.5軟件統(tǒng)計,調(diào)查我院2005-2008年ROP的篩查陽性率、篩查比例、隨訪比例及不同出生體重和胎齡構(gòu)成比例、危重病例構(gòu)成比例的變化趨勢,分析ROP篩查陽性率的變化趨勢及相關(guān)影響因素。計數(shù)資料中各研究指標(biāo)的變化趨勢使用卡方檢驗中的Cochran-Armitage Trend Test,各因素與ROP篩查陽性率的相關(guān)性用Correlations Spearman。 結(jié)果: 1.2005-2008年我院ROP篩查陽性率分別為5.8%、8.5%、13.2%、14.5%,呈逐年上升趨勢;閾值以上ROP發(fā)生比例分別為1.9%、1.9%、2.0%、2.3%,無統(tǒng)計學(xué)意義。 2.四年中出生體重1500g研究對象ROP篩查陽性率為19.1%,1500g-1999g ROP篩查陽性率為5.8%,兩者相關(guān)分析有顯著統(tǒng)計學(xué)意義(R=0.20, P0.01);出生胎齡32w研究對象ROP篩查陽性率18.3%,出生胎齡≥32w ROP篩查陽性率4.9%,兩者相關(guān)分析有顯著統(tǒng)計學(xué)意義(R=0.20, P0.01);危重病例ROP篩查陽性率15.4%;非危重病例ROP篩查陽性率5.6%,兩者相關(guān)分析有顯著統(tǒng)計學(xué)意義(R=0.14,P0.01)。 3.2005-2008年篩查比例分別為56.0%、81.3%、93.1%、93.7%;隨訪比例分別為44.8%、54.4%、62.4%、75.3%;完成隨訪病例中出生體重1500g構(gòu)成比例分別為40.4%、42.5%、45.7%、52.1%,出生胎齡32w構(gòu)成比例分別為42.3%、50.0%、54.3%、57.3%,危重病例所占比例分別為51.9%、60.4%、67.5%、71.4%;經(jīng)Cochran-Armitage Trend Test分析,均呈逐年上升趨勢,經(jīng)Correlations Spearman分析,均與ROP篩查陽性率的變化趨勢相關(guān)。 結(jié)論: 1.本調(diào)查顯示2005-2008年ROP篩查陽性率從5.8%上升至14.5%,呈逐年上升趨勢,但閾值以上ROP無明顯增加。 2.極低體重兒和小胎齡兒比例增加、危重病例比例增加及規(guī)范管理是影響ROP篩查陽性率變化趨勢的相關(guān)因素。 3.建議基層醫(yī)院及時將危重兒、極低出生體重兒和小胎齡兒轉(zhuǎn)運(yùn)到具備氧療檢測條件和搶救技術(shù)的醫(yī)院,更加注重規(guī)范用氧,強(qiáng)調(diào)此類患者的綜合管理,是降低ROP發(fā)生率和致盲率的有效干預(yù)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.
【學(xué)位授予單位】：廣州醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2010
【分類號】：R774.1

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