Prematüre yenidoğanlarda prematüre retinopatisi sıklığı ve etki eden risk faktörlerinin değerlendirilmesi
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Tarih
2017
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Hatay Mustafa Kemal Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
AMAÇ: Bilimsel ve teknolojik gelişmelerle birlikte prematüre bebeklerin yaşam şansları artmaktadır. Bununla birlikte, prematüre bebeklerin en önemli görme sorunu olan prematüre retinopatisinin sıklığı de artmaktadır. Bu çalışmada prematüre retinopatisi sıklığımızı ve etki eden risk faktörlerinin belirlenmesini amaçladık. YÖNTEM: Çalışmamızda, Mustafa Kemal Üniversitesi Tıp Fakültesi Yenidoğan Yoğun Bakım Ünitesi'nde Ekim 2014-Haziran 2016 tarihleri arasında yatarak tedavi gören gebelik haftası <37 hafta olan, 148 hasta dosyası retrospektif olarak değerlendirildi. BULGULAR: Sonuçlar değerlendirildiğinde, vakaların 63 (%42,6)' ünün kız, 85 (%57,4)'inin erkek olduğu tespit edildi. Toplam 23 (%15,5) vakada prematüre retinopatisi geliştiği tespit edildi. Bunların 12 (%8,1)' sinde Evre 1, 8 (%5,4)' inde Evre 2 ve 3 (%2)' ünde Evre 3 prematüre retinopatisi geliştiği saptandı. Doğum ağırlığının ve gebelik haftasının düşüklüğü, annede erken membran rüptürü öyküsünün olması, 1. ve 5. dakika APGAR skoru düşüklüğü, hastanede yatış süresi, toplam O2 desteği süresi, CPAP' a bağlanma süresi, invaziv mekanik ventilatöre bağlanma süresi, sepsis, bronkopulmoner displazi, patent duktus arteriousus, transfüzyon desteği, sürfaktan uygulaması ile prematüre retinopatisi arasında anlamlı ilişki tespit edildi. Cinsiyet, çoğul gebelik, doğum şekli, fototerapi uygulaması ve nekrotizan enterokolit ve ile prematüre retinopatisi arasında anlamlı ilişki tespit edilemedi. Takiplerinde prematüre retinopatisi gelişen 23 vakadan; 18 (%78)' inde spontan regresyon olduğu, 5 (%22)' inde ise anti-VEGF ve/veya lazer fotokoagülasyonla tedavi edildiği tespit izlendi. SONUÇ: Körlüğe kadar gidebilen görme bozuklukları ile sonuçlanan prematüre retinopatisi multifaktoriyel bir hastalıktır. Yenidoğan yoğun bakımlarda kullanılan tedavi yöntemlerinin gelişmesi ile birlikte prematüre retinopatisi risk faktörlerinin de güncellenmesi ve yeni önerilerin geliştirilmesi gerekmektedir. Böylece önlemlerin alınması ve etkin tarama programı ile prematüre retinopatisi sıklığının azalması sağlanacaktır. AnahtarKelimeler: Prematürite, prematüre retinopatisi, risk faktörleri
AIM: Survival rate of premature newborns increases, thanks to scientific and technological developments. However, this brings along an increase in the incidence of premature retinopathy, which is the most severe visual impairment in premature newborns. In this study, we aim to investigate the incidence of premature retinopathy and to determine the contributing risk factors among premature newborns in our Newborn Intensive Care Unit. METHODS: : In this study, 148 files of patients, who were treated Newborn Intensive Care Unit of the department of Pediatrics in Medical School of Mustafa Kemal University between October 2014 and June 2016, are evaluated retrospectively. Gestation periods of the patients are less than 37 weeks. Retina examinations of the patients were done by the department of Ophthalmology in Medical School of Mustafa Kemal University. RESULTS: 63 (42.6%) of the cases were female and 85 (57.4%) were male. In retina examinations, premature retinopathy was detected in 23 (15.5%) of the cases in total. Among the cases which were diagnosed with premature retinopathy, 12 of the cases (8.1%) were in Stage 1, 8 (5.4%) were in Stage 2, and 3 of the cases (2%) were in Stage 3. Substantial correlations are found between premature retinopathy and low birth weight, short gestation period, premature membrane rupture, low APGAR score at 1st and 5th minute, duration of hospitalization, total duration of O2 supplementation, duration of connection to CPAP, duration of connection to invasive mechanical ventilator, sepsis, bronchopulmonary dysplasia, patent ductus arteriosus, transfusion support and surfactant application. No substantial correlations are found between premature retinopathy and gender, multiple pregnancies, method of childbirth, application of phototherapy, necrotizing enterocolitis. Out of 23 cases which developed premature retinopathy, 18 (78%) were diagnosed with spontaneous regression and 5 (22%) were treated receive anti-VEGF therapy and/or laser photocoagulation. CONCLUSION: Premature retinopathy, which results in visual impairments that can lead to blindness, is a multi-factorial disease. With the developments of treatment methods in Newborn Intensive Care Units, an update is needed for risk factors of premature retinopathy and for related suggestions. We think that by determining the contributing factors, taking precautions and providing an effective screening program, the incidence of premature retinopathy can be decreased.
AIM: Survival rate of premature newborns increases, thanks to scientific and technological developments. However, this brings along an increase in the incidence of premature retinopathy, which is the most severe visual impairment in premature newborns. In this study, we aim to investigate the incidence of premature retinopathy and to determine the contributing risk factors among premature newborns in our Newborn Intensive Care Unit. METHODS: : In this study, 148 files of patients, who were treated Newborn Intensive Care Unit of the department of Pediatrics in Medical School of Mustafa Kemal University between October 2014 and June 2016, are evaluated retrospectively. Gestation periods of the patients are less than 37 weeks. Retina examinations of the patients were done by the department of Ophthalmology in Medical School of Mustafa Kemal University. RESULTS: 63 (42.6%) of the cases were female and 85 (57.4%) were male. In retina examinations, premature retinopathy was detected in 23 (15.5%) of the cases in total. Among the cases which were diagnosed with premature retinopathy, 12 of the cases (8.1%) were in Stage 1, 8 (5.4%) were in Stage 2, and 3 of the cases (2%) were in Stage 3. Substantial correlations are found between premature retinopathy and low birth weight, short gestation period, premature membrane rupture, low APGAR score at 1st and 5th minute, duration of hospitalization, total duration of O2 supplementation, duration of connection to CPAP, duration of connection to invasive mechanical ventilator, sepsis, bronchopulmonary dysplasia, patent ductus arteriosus, transfusion support and surfactant application. No substantial correlations are found between premature retinopathy and gender, multiple pregnancies, method of childbirth, application of phototherapy, necrotizing enterocolitis. Out of 23 cases which developed premature retinopathy, 18 (78%) were diagnosed with spontaneous regression and 5 (22%) were treated receive anti-VEGF therapy and/or laser photocoagulation. CONCLUSION: Premature retinopathy, which results in visual impairments that can lead to blindness, is a multi-factorial disease. With the developments of treatment methods in Newborn Intensive Care Units, an update is needed for risk factors of premature retinopathy and for related suggestions. We think that by determining the contributing factors, taking precautions and providing an effective screening program, the incidence of premature retinopathy can be decreased.
Açıklama
Anahtar Kelimeler
Çocuk Sağlığı ve Hastalıkları, Child Health and Diseases, Prematurity, premature retinopathy, risk factors
