Turkiye Klinikleri Journal of Pediatrics

.: ORIGINAL RESEARCH
Prematüre Retinopatisinde Neonatal Risk Faktörleri ve İnsidans
Neonatal Risk Factors and Incidence of Retinopathy of Prematurity
Tülin ARAS ÖĞREDENa, Zeynep SEYMENa, İrfan PERENTEb, Erdem ERİSc, Serdar CÖMERTd, Gülşen ACARd
aSağlık Bilimleri Üniversitesi İstanbul Eğitim Araştırma Hastanesi, Göz Hastalıkları ABD, İstanbul, TÜRKİYE
bSağlık Bilimleri Üniversitesi Beyoğlu Göz Eğitim Araştırma Hastanesi, Göz Hastalıkları ABD, İstanbul, TÜRKİYE
cSağlık Bilimleri Üniversitesi Dr. Behçet Uz Çocuk Hastalıkları ve Cerrahisi Eğitim ve Araştırma Hastanesi, Göz Kliniği, İzmir, TÜRKİYE
dSağlık Bilimleri Üniversitesi İstanbul Eğitim Araştırma Hastanesi, Çocuk Hastalıkları ABD, İstanbul, TÜRKİYE
Turkiye Klinikleri J Pediatr. 2020;29(2):65-74
doi: 10.5336/pediatr.2019-71290
Article Language: TR
Full Text
ÖZET
 Amaç: Yenidoğan yoğun bakım ünitesinde izlenen olgularda prematüre retinopatisi [retiopathy of prematurity (ROP)] görülme sıklığını, risk faktörlerini ve tedavi sonuçlarını değerlendirmektir. Gereç ve Yöntemler: Ocak 2015-Nisan 2017 tarihleri arasında yoğun bakım ünitesinde yatarak tedavi gören 128 hasta retrospektif olarak değerlendirildi. Herhangi bir evre ROP tespit edilmeyen ve edilenler olmak üzere iki gruba ayrıldı. Hastalar 25 farklı neonatal risk faktörü açısından tarandı. Niceliksel verilerin analizinde Mann-Whitney U, niteliksel verilerde ki-kare test kullanıldı. Etki düzeyleri binary lojistik regresyon analizi ile araştırıldı. Bulgular: Toplamda (n=128) ROP oranı %35,2 bulundu. Bu oran 28 hafta ve altında %67,6, 29 ile 32 hafta arasında %35,4 ve 33 hafta üzerinde %5,7 bulundu. ROP, 1.000 g altındaki olgular için %78,9, 1.000-1.500 g arasında %42,5, 1.500 g üzerinde %12,7 olarak tespit edilmiştir. Doğum haftası ve kilosu ile ROP sıklığı ters orantılıydı. Serbest oksijen uygulanan gün sayısı, nazal sürekli pozitif hava yolu basıncı [continuous positive airway pressure (CPAP)] ve entübasyon uygulama gün sayısı ROP riskini arttırmaktaydı (her biri p=0,000). Son ikisi bağımsız risk faktörü olarak bulunmuştur (sırasıyla odds=1,223 ve 1,408). Pnömotoraks, BPD ve RDS varlığı riski arttırmakta (sırasıyla p=0,050, p=0,000, p=0,002), surfaktan uygulaması (odds=0,038) bağımsız risk faktörü olarak görülmektedir. Transfüzyon sayısı (p=0,000), resüsitasyon (p=0,013), 1. ve 5. dakika APGAR skoru (sırasıyla p=0,001, p=0,000) uzamış TPN (p=0,000, İKK (p=0,000), kafein kullanımı (p=0,037), sepsis (p=0,002) ve fenobarbital (p=0,003) ROP hastalığı ile ilişkili bulunmuştur. Anemi (p=0,060), çoğul gebelik (p=0,191), fototerapi (p=0,263), hipotansiyon (p=0,577), inotropik kullanımı (p=0,620), hipoglisemi (p=0,905), hipotiroidi (p=0,947), NEK (p=0,661) ve PDA (p=0,150) ROP ile ilişkili bulunmamıştır. Tedavide 12 olguya diod lazer fotokoagülasyon, 8 hastaya intavitreal enjeksiyon,2 olguya kombine tedavi uygulandı. Komplikasyon izlenmedi. Sonuç: ROP gelişiminde doğum hafta ve kilosu ile birlikte entübasyon ve nazal CPAP süresi ile sürfaktan uygulaması en önemli risk faktörleridir.

Anahtar Kelimeler: Prematüre retinopatisi; risk faktörleri; epidemiyoloji; oksijen solunum tedavisi; sürekli pozitif havayolu basıncı; entübasyon intratrakeal; pulmoner sürfaktanlar
ABSTRACT
 Objective: To evaluate the incidence, risk factors and outcomes of retinopathy of prematurity (ROP) in neonatal intensive care unit. Material and Methods: Cases (n=128) who were hospitalized in neonatal intensive care unit were evaluated by retrospective method between January 2015-April 2017. The cases were divided into two groups: Those with and without ROP. Cases were screened for 25 different neonatal risk factors. For analysis Mann- Whitney U test and chi-square test were used. The effect levels were investigated by binary logistic regression analysis. The results of the treated group were evaluated. Results: Different oxygen therapy modalities(free oxygen, nasal-continuous positive airway pressure (CPAP) and intubation] increased the risk of ROP (p=0.000 for each). The last two of them were found to be independent risk factors (odds= 1.223 and 1.408, respectively). Pneumothorax, BPD and RDS increased the risk (p=0.050, p=0.000, p=0.002, respectively). Surfactant (odds=0.038) observed as an independent risk factor. Transfusion (p=0.000), resuscitation (p=0.013), APGAR 1st and 5th minute scores (p=0.001, p=0.000, respectively), prolonged TPN (p=0.000), ICH (p=0.000), caffeine therapy (p=0.037), sepsis (p=0.002) and phenobarbital (p=0.003) were associated with ROP. Anemia (p=0.060), multiple pregnancy (p=0.191), phototherapy (p=0.263), hypotension (p=0.577), inotropic use (p=0.620), hypoglycemia (p=0.905), hypothyroidism (p=0.947), NEC (p=0.661) and PDA (p=0.150) were not associated with ROP. Diode laser photocoagulation was performed in 12 cases, intravitreal injection in 8 cases, and combined treatment in 2 cases. No complications were observed. Conclusion: The most important risk factors in the development of ROP are duration of intubation and nasal cpap and surfactant therapy together with gestational week and weight.

Keywords: Retinopathy of prematurity; risk factors; epidemiology; oxygen inhalation therapy; continuous positive airway pressure; intubation intratracheal; pulmonary surfactants
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"Turkiye Klinikleri" is not responsible for executing late or never of this hereby "Terms of Use", privacy policy and "USER Contract" in any situation legally taken into account as force majeure. Being late or failure of performance or non-defaulting of this and similar cases like this will not be the case from the viewpoint of "Turkiye Klinikleri", and "Turkiye Klinikleri" will not have any damage liability for these situations. "Force majeure" term will be regarded as outside of the concerned party's reasonable control and any situation that "Turkiye Klinikleri" cannot prevent even though it shows due diligence. Also, force majeure situations include but not limited to natural disasters, rebellion, war, strike, communication problems, infrastructure and internet failure, power cut and bad weather conditions.

8. LAW AND AUTHORISATION TO FOLLOW

Turkish Law will be applied in practicing, interpreting the hereby "Terms of Use" and managing the emerging legal relationships within this "Terms of Use" in case of finding element of foreignness, except for the rules of Turkish conflict of laws. Ankara Courts and Enforcement Offices are entitled in any controversy happened or may happen due to hereby contract.

9. CLOSING AND AGREEMENT

Hereby "Terms of Use" come into force when announced in the "SITE" by "Turkiye Klinikleri". The users are regarded to agree to hereby contract terms by using the "SITE". "Turkiye Klinikleri" may change the contract terms and the changes will be come into force by specifying the version number and the date of change on time it is published in the "SITE".

 

30.03.2014

Privacy Policy

We recommend you to read the terms of use below before you visit our website. In case you agree these terms, following our rules will be to your favor. Please read our Terms of Use thoroughly.

www.turkiyeklinikleri.com website belongs to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. and is designed in order to inform physicians in the field of health

www.turkiyeklinikleri.com cannot reach to user’s identity, address, service providers or other information. The users may send this information to the website through forms if they would like to. However, www.turkiyeklinikleri.com may collect your hardware and software information. The information consists of your IP address, browser type, operating system, domain name, access time, and related websites. www.turkiyeklinikleri.com cannot sell the provided user information (your name, e-mail address, home and work address, phone number) to the third parties, publish it publicly, or keep it in the website. Gathered information has a directing feature to be a source for the website’s visitor profile, reporting and promotion of the services.

www.turkiyeklinikleri.com uses the taken information:

-To enhance, improve and maintain the quality of the website

-To generate visitor’s profile and statistical data

-To determine the tendency of the visitors on using our website

-To send print publications/correspondences

-To send press releases or notifications through e-mail

-To generate a list for an event or competition

By using www.turkiyeklinikleri.com you are considered to agree that;

-Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. cannot be hold responsible for any user’s illegal and immoral behavior,

-Terms of use may change from time to time,

-It is not responsible for other websites’ contents it cannot control or the harms they may cause although it uses the connection they provided.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. may block the website to users in the following events:

-Information with wrong, incomplete, deceiving or immoral expressions is recorded to the website,

-Proclamation, advertisement, announcement, libelous expressions are used against natural person or legal identity,

-During various attacks to the website,

-Disruption of the website because of a virus.

Written, visual and audible materials of the website, including the code and the software are under protection by legal legislation.

Without the written consent of Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. the information on the website cannot be downloaded, changed, reproduced, copied, republished, posted or distributed.

All rights of the software and the design of the website belong to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. will be pleased to hear your comments about our terms of use. Please share the subjects you think may enrich our website or if there is any problem regarding our website.

info@turkiyeklinikleri.com