湖南省三甲医院早产儿视网膜病变防治现状

Prevention and treatment of retinopathy in prematurity in Grade Ⅲ A hospitals of Hunan Province

摘要:

目的：探讨湖南省三甲医院早产儿视网膜病变(ROP)防治现状及其制约因素。

方法：采取分层随机抽样的方法，从湖南省13个地级市和1个自治州中抽取设立新生儿重症监护病房的三甲医院20家。对医院新生儿科负责人派发《医院ROP防治情况调查表》，以此了解三甲医院新生儿氧疗监测情况、ROP筛查和治疗情况、医院开展ROP培训和管理情况、卫生行政部门督导情况及开展ROP防治工作的制约因素。

结果：本研究有效回收调查表20份。20家(100%)医院均开展了氧疗监测，12家(60%)医院开展了ROP筛查，3家(15%)医院开展了ROP治疗，2家(10%)医院同时开展了ROP筛查和治疗，5家(25%)医院进行了ROP防治专项培训，4家(20%)医院所属地卫生行政部门开展了ROP防治督导工作。省部级三甲医院开展ROP治疗、专项培训及督导情况均好于地市级三甲医院。ROP防治的主要制约因素包括缺乏专业技术人才、防治设备、规范化培训及重症患儿治疗风险大。

结论：湖南省三甲医院新生儿氧疗监测情况较好，但ROP的筛查及治疗现状不容乐观，应加强开展ROP防治专项技能培训及督导工作，进一步提高ROP整体防治水平。

Abstract:

AIM: To investigate the present situation and restrictive factors about the prevention and control of retinopathy of prematurity in Grade Ⅲ A hospitals of Hunan Province.

METHODS: A total of 20 hospitals with neonatal intensive care unit were selected from 13 prefecture level cities and 1 autonomous prefectures in Hunan Province by stratified random sampling method. The questionnaires for prevention and treatment of retinopathy of prematurity in hospital were distributed to the hospital officers in order to survey the condition of oxygen monitoring, ROP screening and treatment, ROP training in hospitals and the supervision of health administration departments and the restrictive factors for prevention and treatment of ROP.

RESULTS: Totally 20 questionnaires were collected. There were 20(100%)hospitals carried out oxygen monitoring, 12(60%)hospitals conducted ROP screening, 3(15%)hospitals conducted ROP treatment, 2(10%)hospitals conducted ROP screening and treatment, 5(25%)hospitals conducted special training for prevention and treatment of ROP and 4(20%)local health administration conducted supervision for prevention and control of ROP. The situation of treatment, special training and supervision for ROP in provincial Grade Ⅲ A hospitals were better than ministerial Grade Ⅲ A hospitals. The main restrictive factors of ROP were lack of professional and technical talents, equipment for prevention and treatment, standardized training and the great risk of treatment in children with severe disease.

CONCLUSION: The oxygen monitoring for newborns in Grade Ⅲ A hospitals were good, but the present situation of screening and treatment about ROP is not optimistic. The training of special skills and supervision for prevention and treatment of ROP should be strengthened to further improve the overall level of ROP prevention and control.