Effects of neonatal intensive care unit-centered regional transport network on treatment of retinopathy of prematurity
10.3760/cma.j.issn.1007-9408.2019.09.005
- VernacularTitle: 以新生儿重症监护病房为基地的区域型早产儿视网膜病变治疗网络效果分析
- Author:
Qiuping LI
1
;
Zonghua WANG
2
;
Xiumei YANG
2
;
Haihua CHEN
1
;
Hongyi TANG
1
;
Zhichun FENG
1
Author Information
1. Neonatal Intensive Care Unit, Bayi Children's Hospital Affiliated to the Seventh Medical Center of PLA General Hospital, Beijing 100700, China
2. Department of Ophthalmology, the Seventh Medical Center of PLA General Hospital, Beijing 100700, China
- Publication Type:Journal Article
- Keywords:
Retinopathy of prematurity;
Intensive care units, neonatal;
Patient handoff;
Treatment outcome
- From:
Chinese Journal of Perinatal Medicine
2019;22(9):627-632
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effects of neonatal intensive care unit (NICU)-centered regional neonatal transport network (NTN) on the treatment of retinopathy of prematurity (ROP).
Methods:A retrospective analysis was conducted to analyze the transfer, treatment and outcomes of 406 preterm infants with ROP who were transferred to the Bayi Children's Hospital Affiliated to the Seventh Medical Center of PLA General Hospital via the NTN from July 2008 to December 2014. Independent sample t-test, Chi-square test and Mann-Whitney nonparametric test were used for statistical analysis.
Results:Among the 406 premature infants who were transferred to our hospital because of ROP, there were 257 males and 149 females with the gestational age of (29.5±1.9) weeks (24+5-36 weeks) and the birth weight of (1 234.8± 268.9) g (580-2 400 g). The age at transfer was (48.9±18.5) d (15-78 d) and the transport distance was (216.5±78.6) km (10-625 km). No death was reported during the transportation. Very preterm births and very low birth weight infants (VLBWI) accounted for 88.7% (360 cases) and 82.5% (335 cases), respectively. Lesions occurred in 1, 2 and 3 zones were detected in 98 (24.1%), 286 (70.4%) and 22 (5.4%) cases, respectively. Lesions of stage 1-5 were observed in 51 (12.6%), 156 (38.4%), 183 (45.1%), 12 (3.0%) and 4 (1.0%) cases. There were 186 cases (45.8%) with Plus lesions. A total of 252 cases (62.1%) underwent surgery which were achieving treatment standards, including 165 (65.5%) undergoing laser therapy, 93 (36.9%) receiving anti-vascular endothelial growth factor (VEGF) therapy, 16 (6.4%) having vitrectomy and two (0.8%) having scleral buckling. Eighteen infants were diagnosed with retinal structural abnormalities, among which 16 had retinal detachment before admission (12 in phase 4 and four in phase 5). Two without retinal detachment on admission developed to phase 4 after surgery. The incidence of retinal structural dysplasia was 0.9% (2/236) in infants receiving laser and/or anti-VEGF therapy in our hospital. Compared with the cured patients (n=234), those with retinal structural dysplasia (n=18) had a late transfer time [80 (38-270) vs 50 (19-150) d, Z=3.387, P<0.001].
Conclusions:The NICU-centered and regional transfer-based ROP treatment network provides timely and effective treatment for infants with ROP.
