順天堂大学伊豆長岡病院新生児集中治療室（NICU）における未熟児網膜症の現状およびその予防について

Current status and prevention of retinopathy of prematurity in our neonatal intensive care unit (NICU)

　順天堂伊豆長岡病院新生児集中治療室，（NICU）で，1982年4月の開設より1983年12月までに管理された低出生体重児217例中40例（18.4％）に未熟児網膜症が発症し，1例両眼4度の瘢痕となった．1983年度の静岡県東部地区（芝川町・富士宮市を除く）における発症率は，約0.25（32／13,000）％であった．

　出生体重1,500〜1,999gにもかかわらず，特発性呼吸窮迫症候群（IRDS）および無呼吸発作にて挿管を行った症例は高率（54.5％）に発症しており，これらの症例は1,500g未満と同様に注意深くfollow upする必要があると考えられた．

　超未熟児己（1,000g未満）の新生児死亡率が低下し，超未熟児の占める割合が7％（15／217）と増加したが，混合型Ⅱ型の発症率に増加傾向はなかった．低出生体重児の母親の約半数が，流早産の既往あるいは今回の妊娠経過の異常を伴っていたことから，未熟児出生の予防のためにもこのような状態にある妊婦に対する妊娠中の異常の早期発見，早期治療に関する啓蒙の必要性を感じた．

We evaluated a series of 40 cases with retinopathy of prematurity (ROP) among 217 infants with low-birthweight during the foregoing 21 months in our neonatal intensive care unit.

In the present series, 17 cases showed type I stage 2 of ROP, 19 cases type I stage 3, 1 case mixed stage, and 3 cases type II.

Particular care was needed for cases with a history of tracheal intubation because of idiopathic respi-ratory distress syndrome and apnea, even in infants whose birthweight was between 1,500 and 1,999g. The incidence of ROP was 55%. Cryoretinopexy and/or photocoagulation were performed whenever deemed necessary.

In spite of considerable increase in the incidence of very low birthweight infants during the foregoing 10 years, the incidence of rush or type II ROP re-mained almost stable.

About 50% of mothers who gave birth to low birthweight infants had a history of abortion, imma-ture delivery or some abnormality during pregnancy.

The overall incidence of ROP in this district was 32/13,000 cases (0.25%).