早产儿视网膜病变激光治疗的疗效分析VIP免费

·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...