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台中榮總早產兒視網膜病變之篩檢及治療
Experience of Screening and Treatment of Retinopathy of Prematurity in Taichung Veterans General Hospital
摘要
台中榮民總醫院眼科從1992年3月開始，針對早產兒視網膜病變做計劃性的篩檢。篩檢對象為本院出生或他院轉診之早產兒，生出體重低於1500公克，或懷孕週數少於32週，以及出生時有其他嚴重合併症須氧氣治療者。截至1995年6月，受檢之131位早產兒，檢出早產兒視網膜病變共44例占32.8%，其中46眼達到須要治療之程度，占早產兒視網膜病變之52.2%。早產兒中體重低於1500公克者檢出率高達45%，懷孕週數小於32週者，檢出率高達43%。比較無早產兒視網膜病變之正常組、未達治療閥值組與達到治療閥值組，三組的平均出生體重和懷孕週數在統計學上均有顯著差異，早產兒視網膜病變之檢出率及嚴重程度在低出生體重及低懷孕週數之比例較高，接受冷凍或雷射治療有46眼，治療後病變持續進行者有15眼，占32.6%，15眼全部是影響區間Ⅰ(Zone Ⅰ)或區間Ⅰ、Ⅱ交接處之病例，冷凍治療失敗率為42.3%，雷射治療失敗率為20%，但是冷凍治療組中區間Ⅰ病例本就高達42.3%。有3例眼為第四期(Stage 4A)，但只影響區間Ⅱ(Zone Ⅱ)，其治療效果良好。
關鍵字
無資料並列摘要
Screening program for retinopathy of prematurity (ROP) in Taichung VGH started since March, 1992. All infants of birth body weigh (BBW) below 1500 gm or gestational age (GA) less than 32 weeks, and/or receiving supplemental oxygen therapy due to severe neonatal complication, either born in our hospital or transferred from other hospitals, underwent ophthalmic examination. Between March 1992 and June 1995, 131 prematurity (262 eyes) completed the screening program. 86 eyes (32.8%) developed ROP, of whom 46 eyes (52.2%) developed threshold ROP. 45% babies with BBW less than 1500 gm developed ROP, while 43% babies born with GA less 32 weeks developed ROP. There was significant difference between the 3 subgroups of babies without ROP, non-threshold ROP and threshold ROP. The incidence and severity of ROP correlated with BBW and GA. 46 eyes with threshold ROP received cryotherapy or laser indirect ophthalmoscopy (LIO); 15 eyes (32.6%) progressed after treatment, all of them were classified to be in zone Ⅰ or zone Ⅰ-Ⅱ junction. Failure rate in cryotherapy group were 42.3%, while 20% in LIO group. The percentage of patients with zone Ⅰ disease in cryotherapy group shown to be 42.3% and was twice as LIO group. There were 3 eyes with stage 4A, involved zone Ⅱ only, got favorable outcome.