Analysis of the effect of intensive therapy of premature infants on the development of neonatal retinopathy

A. I. Lopatin, V. V. Andreev, N. A. Pasatetskaya, M. G. Sokolova, E. V. Lopatina
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Abstract

Retinopathy of prematurity is one of the most severe diseases that lead to permanent blindness from early childhood. The frequency of retinopathy of prematurity in neonatology closely correlates with the degree of maturity of the child’s body. Goal. To conduct a analysis of the correlation of the degree of oxygenation, the number of blood transfusions with the severity of progressive retinopathy in newborns. The study included 40 premature infants diagnosed with retinopathy of newborns who were being treated in the neonatal intensive care unit. Conducted: clinical and diagnostic examination of patients; analysis of the dependence of the degree of oxygenation, the number of blood transfusions, gestational age, inotropic support and the severity of retinopathy. Materials and methods . Out of 40 patients diagnosed with neonatal retinopathy, 6 children were operated on. Results and discussion . The study showed that all the operated children were born at a gestation period of less than 29 weeks, were treated with antibacterial and inotropic drugs. There was no direct relationship between the number of blood transfusions and the risk of developing a severe form of the disease with further surgical treatment. In 40% of cases, children who developed retinopathy of stages 1 and 2 did not receive transfusion of erythrocyte suspension at all. At the treatment stage, all operated patients received a gas-air mixture with an oxygen content above 45%, as well as inotropic and vasopressor support with epinephrine and norepinephrine. Statistical analysis has shown that the number of blood transfusions is not the leading factor in the decision to refer a child for surgery. Among children with a gestation period of less than 29 weeks, retinopathy of varying severity was found in all infants; in the group of children aged 30–35 weeks, the disease developed only in 45% of patients. Conclusion. The conducted studies have shown that the parameter number of hours spent using IVL (the parameter artificial lung ventilation) is informative, and parameters such as weight and gestational age are significant. It is necessary to note the importance of additional parameters. Among the operated children, the condition of severe asphyxia was suffered by 45.5% of children in group A, in Weight groups severe asphyxia was in 28% of cases. Statistical analysis showed that children who required surgical treatment received catecholamine therapy at the initial stages. The most unfavorable percentage of oxygen supplied with the air mixture starts from 40–45%. The children who required surgical treatment received catecholamine therapy at the initial stages.
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早产儿强化治疗对新生儿视网膜病变发展的影响分析
早产儿视网膜病变是导致儿童早期永久失明的最严重疾病之一。新生儿早产儿视网膜病变的发生频率与儿童身体的成熟程度密切相关。的目标。分析新生儿氧合程度、输血次数与进展性视网膜病变严重程度的相关性。该研究包括40名被诊断患有新生儿视网膜病变的早产儿,他们正在新生儿重症监护病房接受治疗。负责:对患者进行临床及诊断检查;分析氧合程度、输血次数、胎龄、肌力支持与视网膜病变严重程度的依赖关系。材料和方法。在40例诊断为新生儿视网膜病变的患者中,有6例儿童接受了手术。结果和讨论。研究表明,所有接受手术的儿童在妊娠期小于29周时出生,并给予抗菌药物和肌力药物治疗。输血次数与进一步手术治疗后发展为严重疾病的风险之间没有直接关系。在40%的病例中,发展为1期和2期视网膜病变的儿童根本没有接受红细胞悬液的输血。在治疗阶段,所有手术患者均接受含氧量45%以上的气体-空气混合物,以及肾上腺素和去甲肾上腺素的肌力和血管加压支持。统计分析表明,输血次数并不是决定儿童是否接受手术的主要因素。在妊娠期小于29周的儿童中,所有婴儿都有不同程度的视网膜病变;在30-35周的儿童组中,只有45%的患者出现这种疾病。结论。所进行的研究表明,使用IVL的小时数参数(人工肺通气参数)具有信息性,体重和胎龄等参数具有重要意义。有必要注意到附加参数的重要性。A组患儿严重窒息率为45.5%,体重组患儿严重窒息率为28%。统计分析显示,需要手术治疗的患儿在初始阶段接受儿茶酚胺治疗。混合气中供氧的最不利百分比从40-45%开始。需要手术治疗的患儿在初始阶段接受儿茶酚胺治疗。
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