Yıl: 2020 Cilt: 29 Sayı: 2 Sayfa Aralığı: 65 - 74 Metin Dili: Türkçe DOI: 10.5336/pediatr.2019-71290 İndeks Tarihi: 05-05-2021

Prematüre Retinopatisinde Neonatal Risk Faktörleri ve İnsidans

Öz:
Amaç: Yenidoğan yoğun bakım ünitesinde izlenen olgulardaprematüre retinopatisi [retiopathy of prematurity (ROP)] görülme sıklığını,risk faktörlerini ve tedavi sonuçlarını değerlendirmektir. Gereçve Yöntemler: Ocak 2015-Nisan 2017 tarihleri arasında yoğun bakımünitesinde yatarak tedavi gören 128 hasta retrospektif olarak değerlendirildi.Herhangi bir evre ROP tespit edilmeyen ve edilenler olmaküzere iki gruba ayrıldı. Hastalar 25 farklı neonatal risk faktörü açısındantarandı. Niceliksel verilerin analizinde Mann-Whitney U, nitelikselverilerde ki-kare test kullanıldı. Etki düzeyleri binary lojistik regresyonanalizi ile araştırıldı. Bulgular: Toplamda (n=128) ROP oranı %35,2bulundu. 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 olgulariçin %78,9, 1.000-1.500 g arasında %42,5, 1.500 g üzerinde %12,7olarak tespit edilmiştir. Doğum haftası ve kilosu ile ROP sıklığı tersorantılıydı. Serbest oksijen uygulanan gün sayısı, nazal sürekli pozitifhava yolu basıncı [continuous positive airway pressure (CPAP)] ve entübasyonuygulama gün sayısı ROP riskini arttırmaktaydı (herbirip=0,000). Son ikisi bağımsız risk faktörü olarak bulunmuştur (sırasıylaodds=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. Transfüzyonsayısı (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), kafeinkullanımı (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. Tedavide12 olguya diod lazer fotokoagülasyon, 8 hastaya intavitreal enjeksiyon,2olguya kombine tedavi uygulandı. Komplikasyon izlenmedi. Sonuç:ROP gelişiminde doğum hafta ve kilosu ile birlikte entübasyon ve nazalCPAP süresi ile sürfaktan uygulaması en önemli risk faktörleridir.
Anahtar Kelime:

Neonatal Risk Factors and Incidence of Retinopathy of Prematurity

Öz:
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.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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APA ÖĞREDEN T, seymen z, Perente I, Eris E, Comert S, ACAR G (2020). Prematüre Retinopatisinde Neonatal Risk Faktörleri ve İnsidans. , 65 - 74. 10.5336/pediatr.2019-71290
Chicago ÖĞREDEN TÜLİN,seymen zeynep,Perente Irfan,Eris Erdem,Comert Serdar,ACAR Gülşen Prematüre Retinopatisinde Neonatal Risk Faktörleri ve İnsidans. (2020): 65 - 74. 10.5336/pediatr.2019-71290
MLA ÖĞREDEN TÜLİN,seymen zeynep,Perente Irfan,Eris Erdem,Comert Serdar,ACAR Gülşen Prematüre Retinopatisinde Neonatal Risk Faktörleri ve İnsidans. , 2020, ss.65 - 74. 10.5336/pediatr.2019-71290
AMA ÖĞREDEN T,seymen z,Perente I,Eris E,Comert S,ACAR G Prematüre Retinopatisinde Neonatal Risk Faktörleri ve İnsidans. . 2020; 65 - 74. 10.5336/pediatr.2019-71290
Vancouver ÖĞREDEN T,seymen z,Perente I,Eris E,Comert S,ACAR G Prematüre Retinopatisinde Neonatal Risk Faktörleri ve İnsidans. . 2020; 65 - 74. 10.5336/pediatr.2019-71290
IEEE ÖĞREDEN T,seymen z,Perente I,Eris E,Comert S,ACAR G "Prematüre Retinopatisinde Neonatal Risk Faktörleri ve İnsidans." , ss.65 - 74, 2020. 10.5336/pediatr.2019-71290
ISNAD ÖĞREDEN, TÜLİN vd. "Prematüre Retinopatisinde Neonatal Risk Faktörleri ve İnsidans". (2020), 65-74. https://doi.org/10.5336/pediatr.2019-71290
APA ÖĞREDEN T, seymen z, Perente I, Eris E, Comert S, ACAR G (2020). Prematüre Retinopatisinde Neonatal Risk Faktörleri ve İnsidans. Türkiye Klinikleri Pediatri Dergisi, 29(2), 65 - 74. 10.5336/pediatr.2019-71290
Chicago ÖĞREDEN TÜLİN,seymen zeynep,Perente Irfan,Eris Erdem,Comert Serdar,ACAR Gülşen Prematüre Retinopatisinde Neonatal Risk Faktörleri ve İnsidans. Türkiye Klinikleri Pediatri Dergisi 29, no.2 (2020): 65 - 74. 10.5336/pediatr.2019-71290
MLA ÖĞREDEN TÜLİN,seymen zeynep,Perente Irfan,Eris Erdem,Comert Serdar,ACAR Gülşen Prematüre Retinopatisinde Neonatal Risk Faktörleri ve İnsidans. Türkiye Klinikleri Pediatri Dergisi, vol.29, no.2, 2020, ss.65 - 74. 10.5336/pediatr.2019-71290
AMA ÖĞREDEN T,seymen z,Perente I,Eris E,Comert S,ACAR G Prematüre Retinopatisinde Neonatal Risk Faktörleri ve İnsidans. Türkiye Klinikleri Pediatri Dergisi. 2020; 29(2): 65 - 74. 10.5336/pediatr.2019-71290
Vancouver ÖĞREDEN T,seymen z,Perente I,Eris E,Comert S,ACAR G Prematüre Retinopatisinde Neonatal Risk Faktörleri ve İnsidans. Türkiye Klinikleri Pediatri Dergisi. 2020; 29(2): 65 - 74. 10.5336/pediatr.2019-71290
IEEE ÖĞREDEN T,seymen z,Perente I,Eris E,Comert S,ACAR G "Prematüre Retinopatisinde Neonatal Risk Faktörleri ve İnsidans." Türkiye Klinikleri Pediatri Dergisi, 29, ss.65 - 74, 2020. 10.5336/pediatr.2019-71290
ISNAD ÖĞREDEN, TÜLİN vd. "Prematüre Retinopatisinde Neonatal Risk Faktörleri ve İnsidans". Türkiye Klinikleri Pediatri Dergisi 29/2 (2020), 65-74. https://doi.org/10.5336/pediatr.2019-71290