床旁激光治疗早产儿视网膜病变的疗效分析

Bedside treatment of retinopathy of premeturity by laser photocoagulation

摘要:

目的：探讨床旁激光治疗早产儿视网膜病变（ROP）的临床效果。方法：回顾性分析2009年3月至2009年8月在我院新生儿重症监护室（NICU）内床旁激光治疗的30例ROP患儿的临床资料。结果：30例ROP患儿中59只眼接受了激光治疗，总体治愈率95%。根据ROP国际分类标准，30例ROP患儿中，Ⅰ区病变有13例（26眼），Ⅱ区病变有17例（33眼）。Ⅰ区病变组平均出生胎龄、体重及治疗时纠正胎龄均明显低于Ⅱ区病变组，而激光斑点数量明显高于Ⅱ区病变组。Ⅱ区病变组治愈率（100%）明显高于Ⅰ 区病变组（88%）（P<0.05）。结论：NICU床边激光手术治疗Ⅰ区病变和Ⅱ区病变是有效的。与Ⅱ区病变相比，Ⅰ区病变患儿预后相对较差。［中国当代儿科杂志，2010，12（9）：696-699］

Abstract:

OBJECTIVE: To study the efficacy of bedside treatment by laser photocoagulation for retinopathy of prematurity (ROP) in preterm infants hospitalized in the Neonatal Intensive Care Unit (NICU). METHODS: The clinical data of 30 cases of ROP who underwent peripheral laser ablation on bedside in the NICU from March to August 2009 were studied retrospectively. RESULTS: A total of 59 eyes from 30 patients received the laser therapy, with a total cure rate of 95%. According to the International Classification of ROP, 26 eyes of 13 infants had zone 1 disease, and 33 eyes of 17 infants had zone 2 disease. The birth gestational age and birth weight as well as corrected gestational age and corrected weight at operation in the zone 1 disease group were significantly lower than those in the zone 2 disease group. The number of laser spots in the zone 1 disease group was significantly higher than that in the zone 2 disease group. The cure rate in the zone 2 disease group (100%) was significantly higher than that in the zone 1 disease group (88%). CONCLUSIONS: Laser retinal photocoagulation on bedside in the NICU is effective for both zone 1 and zone 2 ROP. As compared with the infants with zone 2 disease, the infants with zone 1 disease may have a poor outcome. ［Chin J Contemp Pediatr, 2010, 12 (9):696-699］