未熟児網膜症の自験例の検討

Review of retinopathy of prematurity in our institution

　1989年4月から3年間に飯田市立病院小児科未熟児室に入院し，眼底検査を依頼された82例について未熟児網膜症の検討を行った。厚生省未熟児網膜症研究班の新分類の2期以上を発症とすると，発症率は出生体重1,000g未満で50％，1,500g未満で68.4％，全体で18.3％であった。網膜症発症は在胎32週未満に集中していて，3期以上に進行したものはすべて29週未満であった。発症因子として，出生体重，在胎週数，酸素投与，呼吸窮迫症候群，胎内発育，輸血，肺サーファクタント，メフェナム酸，観血的動脈圧測定，人工換気の関与が考えられた。4例に網膜冷凍凝固術による治療が行われたが，全例瘢痕1度にとどまった。

We reviewed a consecutive series of 82 premature infants referred to us from the neonatal care unit of lida Municipal Hospital during the foregoing 3-year period. The incidence of retionopathy of prematurity (ROP) of stage 2 or more was 18%.These cases comprised 50% of infants with the birthweight of 1,000 g or less and 68% of 1,500g or less. We used the classification by Japanese Minis-try of Public Welfare. Infants with gestational age less than 32 weeks showed a higher incidence of ROP than those more than 32 weeks. All the infants with ROP of stage 3 or more were of gestational age less than 29 weeks. The occurrence of ROP was significantly related with birthweight, gestational age, oxygen supplementation, respiratory distress syndrome, intrauterine growth, blood transfusion,use of surfactant, mefenamic acid, intraarterial blood pressure monitoring and artificial ventila-tion. Cryopexy was performed in 4 infants. All the eyes healed with grade 1 scar.