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【目的】研究广东省基层医院早产儿视网膜病(retinopathy of prematurity,ROP)筛查现状,探讨基层医疗服务机构ROP防治管理模式。【方法】通过信函、现场和电子邮件的方式对广东省设有新生儿ICU(NICU)的基层医院进行ROP筛查情况调查,调查内容包括氧疗监测情况、是否开展ROP筛查以及近五年筛查例数和阳性率等。【结果】一级医院氧疗监测开展率25.00%,二级医院氧疗监测率51.28%,二级医院较一级医院开展早产儿氧疗监测率高,差异有显著性(P<0.05)。一级医院开展ROP筛查率9.09%,二级医院开展ROP筛查率30.77%,二级医院较一级医院开展ROP筛查率高,差异有显著性(P<0.05)。二级综合医院和二级妇幼保健院开展ROP筛查率分别为27.78%和36.84%,ROP筛查阳性率分别为1.23%和0.98%,差异无显著性(P>0.05)。结论基层医院尚未普遍开展ROP筛查。以行政干预手段促进ROP筛查防治工作势在必行,建议建立以三级医院为依托、覆盖基层医院的网络式ROP筛查防治模式,保证基层医院ROP的防治质量。
【Objective】 To investigate the screening status of retinopathy of prematurity (ROP) in primary hospitals in Guangdong Province and to explore the management mode of ROP prevention and treatment in primary medical service institutions. 【Method】 ROP screening was conducted by letter, on-site and e-mail at the grass-roots level hospitals with neonatal ICU (NICU) in Guangdong Province. The investigation included the monitoring of oxygen therapy, screening for ROP, and the recent five years Screening cases and positive rate and so on. 【Results】 The monitoring rate of oxygen therapy in primary hospitals was 25.00%. The monitoring rate of oxygen therapy in secondary hospitals was 51.28%. The monitoring rate of oxygen therapy in premature infants in secondary hospitals was higher than that of primary hospitals (P <0.05). ROP screening rate was 9.09% in primary hospitals and 30.77% in secondary hospitals. The screening rate of ROP in secondary hospitals was higher than that of primary hospitals (P <0.05). The ROP screening rates in secondary general hospitals and secondary maternal and child health centers were 27.78% and 36.84% respectively, and the ROP screening positive rates were 1.23% and 0.98% respectively, with no significant difference (P> 0.05). Conclusions Primary ROP screening has not been conducted in primary hospitals. It is imperative to promote ROP screening with administrative interventions. It is suggested that a network-based ROP screening prevention and control model based on tertiary hospitals should be established to ensure the quality of ROP prevention and control in primary hospitals.