Abstract
目的 评价早产儿视网膜病(retinopathy of prematurity,ROP)冷凝治疗效果,探讨围手术期管理模式.方法 对370例符合筛查指征的早产儿进行眼底筛查,对25例阈值或Ⅰ型阈值前期病变ROP患儿进行冷凝治疗,术前术后在新生儿病房管理,新生儿科医师负责处理围手术期全身并发症,眼科医师术后定期随访检查眼底.结果 ROP的发生率为22%,阈值和Ⅰ型阈值前期病变发生率为6.8%.56例1期、2期病变未治疗,定期随访眼底恢复正常.25例50只眼阈值、Ⅰ型阈值前病变冷凝治疗成功率为92%,2例4只眼冷凝治疗后发生部分视网膜脱离,经玻璃体视网膜手术病变控制.随访9个月病变控制眼底正常的有44只眼(88%),出现视网膜脱离或后极部视网膜皱褶的有6只眼(12%).6例术后12 h内发生呼吸暂停,3例术后第1天出现窦性心动过速.结论 冷凝治疗可以作为治疗ROP阈值病变的选择,近期疗效较好.ROP围手术期处理的重点是呼吸管理.ROP患儿围手术期处理需要眼科医师和新生儿科医师密切合作共同管理。
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