·208·ChinOphthalRes,March2007,Vo1.2—5—,—N—o.3早产儿视网膜病变激光治疗的疗效分析·临床研究·尹虹黎晓新赵明成梁建宏TreatmentoutcomeofretinopathyofpremeturitybylaserphotocoagulationY/nHong,LiXiaoxin,ZhaoMingwei,LiangJianhong.DepartmentofOphthalmology,PekingUniversityPeople’sHospital,Beqing100044,ChinaAbstractObjectiveTocomparethetreatmentefficacyofindirectdiodelaserforzonesIandzone1Iofretinopathyofprematurity(ROP).MethodsTheclinicalrecordsin42preterminfants(73eyes)treatedinPekingUniversityPeople’sHospitalfrom2002Septemberto2004Junewereretrospectivelyanalyzed.VariousriskfactorswerecomparedbetweenthepatientswithzoneIROPandzoneⅡROP.ResultsSixty—threeeyeswithROPwerecuredviathelaserph0t0c0agulatj0nwiththecurativerate93.15%.Themeanbirthweight,gestationalageandthecorrectedgestationalageatthetimeofoperationin10infantswithzoneIdiseasewas1307.0g,4-295.6g,30weeksand37.4-4-3.89weeks,andthedataabovementionedhadnotsignificantdifferenceincomparisonwiththe32infantswithzoneⅡdiseasegroup(1491.44g±295.94g,30.33weeksand39.41-4-6.44weeks).Two(4eyes)of19infantswithzoneIdiseaseunderwentthesecondlaserand3of32infantsreceivedthesamemanagementinanothergroup.Fiveeyesof3patientsinthezoneIROPgroupprogressedtostageIVbutallpatientswithzone11ROPregressedfollowingthelasertreatment.Theageatsurgeryshowedapositivecorrelationwithcorectedgestationalweeksofinfants(Pearson=0.97,P<0.01)andanegativecorelationwithgestationalage(Pearson=一0.391,P<0.05).NosignificantrelationwasfoundbetweenthezoneofROPinthefollowingparameters:bodyweightatbirth,gestationalweek,ageatsurgeryandcorectgestationalweek(P>0.05)ConclusionDiodelaserretinalph0t0c0agulati0nisasafeandeffectiveprocedurefortreatmentofzoneIandlIofROP.PatientswithzoneIROPalwaysshowapooroutcome、Ageatthetimeofthelaserph0t0c0agulatj0nisassociatedwithgestationalageandcorrectedgestationalageofinfants.Keywordsretinopathyofpremeturity;diodelaserph0t0c0agulati0n;zoneIdisease;zone11disease摘要目的比较激光治疗各区域早产儿视网膜病变(ROP)的临床效果。方法回顾性分析波长810am的二极管激光治疗的42例(73眼)的临床资料。结果42例患儿中I区病变10例19眼(平均胎龄30周),Ⅱ区病变32例54眼(平均胎龄30.33周);治疗时矫正胎龄分别为(37.4±3.89)周和(39.41±6.44)周,I区病变与Ⅱ区病变的出生体重、胎龄及治疗时矫正胎龄无统计学意义;I区病变2例4眼(4/19,21.05%)进行二次激光.Ⅱ区病变3例5眼(5/54,9.26%)进行再激光;I区病变中3例5眼(5/19,26.31%)进展为4期,而Ⅱ区病变的患儿病变全部得到控制;激光时年龄与胎龄负相关而与矫正胎龄正相关。结论二极管激光治疗I区病变和Ⅱ区病变是安全有效的;I区病变激光治疗的预后较差。激光时年龄与胎龄及矫正胎龄有关。关键词早产儿视网膜病变;二极管激光;I区病变;lI区病变分类号774文献标识码A文章编号1003-0808(2007)03-0208-03早产儿视网膜病变(retinopathyofprematurity,ROP)是影响早产儿视力的主要疾病之一。如果未得到及时、有效的治疗可能会导致患儿失明的严重后果,美国ROP冷凝治疗研究小组建议⋯,1期、2期ROP病变仅需密切观察即可,大部分可自行消退,当其发展至严重程度时则需治疗,且冷冻及激光治疗均能取得作者单位:100044北京大学人民医院眼科通讯作者:尹虹(Email:yh638@126.corn)良好的视力预后引,但有报道ROP的部位会影响其治疗预后。我们用波长810nm的二极管激光,治疗了ROP患儿42例(73眼),现将疗效分析报告如下。1资料与方法1.1资料所有病例为2002年9月23日~2005年6月17日我院用二极管激光治疗的42例ROP患儿,其中男维普资讯http://www.cqvip.com眼科研究20...