早產兒視網膜病變相關因素之探討

本研究目的旨在探討那些因素是造成早產兒視網膜病變的危險因子，以及早產兒視網膜病變消退的情形，同時比較有無早產兒視網膜病變二組的病患屬性、醫護措施、檢驗數據、疾病診斷之差異。本研究採回溯病歷的方法，樣本來自於中部某一區域醫院暨教學醫院，於1996年10月1日至1998年9月30日止所有出生第一天即住進新生兒加護病房存活的早產兒且至少留院28天，出生體重在2500公克以下者，其中先天性心臟病、先天畸形、三個月內未追蹤者一律去除，合計195人次。資料以x2、t-test及Logistic regression等統計方法進行分析。 研究結果發現:195個研究對象中有112人(57.4%)罹患早產兒視網膜病變；消退的比率為85%。早產兒視網膜病變會因出生體重、出生28天之體重、出生28天增加之之體重、妊娠週數、輸血量、加護病房住院天數、有無使用呼吸器、survanta之藥物治療、Hb值、貧血診斷、氧氣使用天數而有差異，而氧氣使用天數及出生28天之體重是預測早產兒視網膜病變的重要因子，顯示醫護人員開始照顧早產兒之時，可先參考上述因素，隨時監測，以提供良好的護理照護，預防視網膜病變的發生。

The aim of this study was to investigate risk factors for developing retinopathy of prematurity(ROP) in preterm babies and to describe regression of ROP. We also evaluated the differences in demographic data， medical intervention，laboratory data，and diagnosis between these preterm babies who suffered ROP or not. This study was performed retrospectively from Oct.1,1996,through September 30,1998.195 preterm(gestational age below 37 weeks and birth body weight below 2500 gm) were enrolled， who must stay in neonatal intensive care unit (NICU)for at least 28 days. Infants with congenital heart disease、congenital anomaly and loss follow up for 3 months were excluded. Data were analyzed by chi-square test，t-test and logistic regression. In this study，retinopathy of prematurity was found in 112 infants (53.4%).Among these ROP infants regression rate was 85%.This study also showed that birth body weight，gestational age，use of mechanical ventilator and surfactant，Hemoglobin，Anemia、diagnosis、body weight at 28- day-old，blood transfusion，period of NICU admission and O2 duration were significant difference in developing ROP in preterm infants. Logistic regression analysis indicated that O2 duration and body weight at 28-day-old were correlation with developing ROP.In summary，careful monitor and nursing care may also an important role for preventing development of ROP in preterm infants.