ROP早產(chǎn)兒特殊護(hù)理需求演講人2025-12-0301ROP早產(chǎn)兒特殊護(hù)理需求ONEROP早產(chǎn)兒特殊護(hù)理需求摘要本文系統(tǒng)探討了ROP（視網(wǎng)膜病變）早產(chǎn)兒在護(hù)理過(guò)程中的特殊需求。通過(guò)總分總的結(jié)構(gòu)，詳細(xì)闡述了ROP早產(chǎn)兒的基本情況、護(hù)理評(píng)估、具體護(hù)理措施、并發(fā)癥預(yù)防及護(hù)理、健康教育等方面內(nèi)容。文章旨在為臨床護(hù)理人員提供全面、系統(tǒng)的ROP早產(chǎn)兒護(hù)理指南，以改善護(hù)理質(zhì)量，促進(jìn)患兒康復(fù)。引言早產(chǎn)兒視網(wǎng)膜病變(ROP)是早產(chǎn)兒常見(jiàn)的致盲性眼病，對(duì)患兒的視力發(fā)育具有重要影響。隨著醫(yī)療技術(shù)的進(jìn)步，早產(chǎn)兒的存活率顯著提高，但ROP的發(fā)生率也隨之增加。因此，針對(duì)ROP早產(chǎn)兒的特殊護(hù)理需求進(jìn)行深入研究，對(duì)改善患兒預(yù)后具有重要意義。本文將從多個(gè)維度探討ROP早產(chǎn)兒的護(hù)理要點(diǎn)，為臨床護(hù)理實(shí)踐提供參考。02ROP早產(chǎn)兒基本情況概述ONE1ROP的定義與病理生理機(jī)制ROP是指早產(chǎn)兒在出生后由于視網(wǎng)膜血管發(fā)育不成熟，在氧濃度波動(dòng)的影響下發(fā)生異常血管增生，嚴(yán)重者可導(dǎo)致視網(wǎng)膜脫離甚至失明。其病理生理機(jī)制主要與早產(chǎn)兒視網(wǎng)膜血管發(fā)育階段有關(guān)。正常胎兒在孕28周后才開(kāi)始出現(xiàn)視網(wǎng)膜血管，而早產(chǎn)兒出生時(shí)血管僅到達(dá)視盤水平，視網(wǎng)膜周邊部尚無(wú)血管，這些未發(fā)育的血管對(duì)氧濃度變化極為敏感。2ROP的危險(xiǎn)因素ROP的發(fā)生與多種因素相關(guān)，主要包括早產(chǎn)、低出生體重、高膽紅素血癥、機(jī)械通氣時(shí)間延長(zhǎng)、感染、母體糖尿病等。其中，早產(chǎn)和低出生體重是最重要的危險(xiǎn)因素，胎齡越小、出生體重越低，ROP的發(fā)生率越高。例如，胎齡小于30周的早產(chǎn)兒ROP發(fā)生率為50%以上，而胎齡大于37周者幾乎不發(fā)生ROP。3ROP的分期與分級(jí)ROP根據(jù)病變程度分為5個(gè)階段：階段1為血管前纖維增生；階段2為纖維增生到達(dá)視盤；階段3為纖維增生超過(guò)視盤但未達(dá)血管arcade；階段4為纖維增生超過(guò)血管arcade，分為4a和4b兩級(jí)；階段5為視網(wǎng)膜脫離。其中，階段3及以上屬于重度ROP，需要積極治療。ROP的分期對(duì)于制定護(hù)理計(jì)劃至關(guān)重要，不同階段的護(hù)理重點(diǎn)有所不同。4ROP的治療方法目前ROP的治療方法主要包括激光光凝和冷凍治療。激光光凝通過(guò)破壞病變組織，阻止異常血管增生；冷凍治療則通過(guò)冷凍視網(wǎng)膜表面，使病變組織壞死。治療時(shí)機(jī)對(duì)療效至關(guān)重要，通常在階段3時(shí)開(kāi)始考慮治療。藥物治療如抗VEGF注射也在臨床應(yīng)用中逐漸增多。03ROP早產(chǎn)兒的護(hù)理評(píng)估ONE1入院評(píng)估ROP早產(chǎn)兒入院后需立即進(jìn)行全面評(píng)估，包括生命體征監(jiān)測(cè)、眼科檢查、神經(jīng)系統(tǒng)評(píng)估等。生命體征監(jiān)測(cè)應(yīng)包括呼吸頻率、心率、血氧飽和度等，異常情況需及時(shí)處理。眼科檢查包括視力篩查、眼底檢查等，以確定ROP的分期和嚴(yán)重程度。神經(jīng)系統(tǒng)評(píng)估可發(fā)現(xiàn)早產(chǎn)兒常見(jiàn)的腦室內(nèi)出血、腦發(fā)育遲緩等并發(fā)癥。2OPG篩查評(píng)估ROP的篩查通常在出生后4-6周開(kāi)始，每2-4周復(fù)查一次，直至視網(wǎng)膜血管完全發(fā)育成熟。OPG篩查采用眼底照相技術(shù)，可清晰顯示視網(wǎng)膜血管發(fā)育情況。篩查評(píng)估需注意以下幾點(diǎn)：①確?；純禾幱诎察o狀態(tài)，減少體動(dòng)對(duì)圖像質(zhì)量的影響；②檢查前需充分散瞳，以暴露視網(wǎng)膜周邊部；③對(duì)篩查結(jié)果進(jìn)行專業(yè)判讀，可疑病例需進(jìn)一步檢查。3風(fēng)險(xiǎn)因素評(píng)估對(duì)ROP早產(chǎn)兒的風(fēng)險(xiǎn)因素進(jìn)行全面評(píng)估，包括早產(chǎn)程度、出生體重、母體病史等。風(fēng)險(xiǎn)因素評(píng)估有助于預(yù)測(cè)ROP的發(fā)生率和嚴(yán)重程度，為制定針對(duì)性護(hù)理措施提供依據(jù)。例如，胎齡越小、出生體重越低的早產(chǎn)兒，需要更密切的監(jiān)護(hù)和更全面的護(hù)理。4患兒舒適度評(píng)估舒適度評(píng)估包括體位、疼痛、喂養(yǎng)等方面。體位不當(dāng)可影響眼部血液循環(huán)，加重ROP進(jìn)展；疼痛和不適會(huì)干擾眼科檢查和治療，影響患兒情緒。舒適度評(píng)估需關(guān)注患兒的個(gè)體差異，制定個(gè)性化護(hù)理方案。04ROP早產(chǎn)兒的護(hù)理措施ONE1一般護(hù)理措施1.1環(huán)境管理ROP早產(chǎn)兒應(yīng)安置在光線柔和、安靜的環(huán)境中，避免強(qiáng)光刺激。光線過(guò)強(qiáng)會(huì)刺激視網(wǎng)膜，影響血管發(fā)育。病房應(yīng)保持適宜的溫濕度，避免溫差過(guò)大刺激患兒。同時(shí)，需定期清潔消毒病房，減少感染風(fēng)險(xiǎn)。1一般護(hù)理措施1.2體位管理體位管理對(duì)于ROP早產(chǎn)兒至關(guān)重要。應(yīng)避免長(zhǎng)時(shí)間仰臥，因?yàn)檫@會(huì)增加眼內(nèi)壓力，促進(jìn)ROP進(jìn)展。推薦采用30-45的仰臥位，必要時(shí)可使用側(cè)臥位或俯臥位。體位調(diào)整需輕柔緩慢，避免劇烈運(yùn)動(dòng)刺激患兒。1一般護(hù)理措施1.3喂養(yǎng)管理營(yíng)養(yǎng)支持對(duì)ROP早產(chǎn)兒至關(guān)重要。早產(chǎn)兒胃腸功能不成熟，易出現(xiàn)喂養(yǎng)不耐受。建議采用小容量、高濃度的喂養(yǎng)方式，逐漸增加喂養(yǎng)量。同時(shí)，需監(jiān)測(cè)患兒的血糖、膽紅素等指標(biāo)，避免高血糖和高膽紅素血癥加重ROP。2眼科護(hù)理措施2.1眼部觀察需密切觀察患兒的眼部情況，包括視力、瞳孔、眼位等。異常情況如瞳孔散大、眼位偏斜等可能是ROP進(jìn)展的信號(hào)。同時(shí)，需注意觀察眼部是否有分泌物、紅腫等感染跡象。2眼科護(hù)理措施2.2眼部防護(hù)ROP早產(chǎn)兒的眼部防護(hù)非常重要。應(yīng)避免患兒的眼睛接觸水或其他液體，以防感染。在洗澡或游泳時(shí)需使用護(hù)目鏡。同時(shí)，需避免劇烈運(yùn)動(dòng)或體位突然改變，減少眼部受沖擊的風(fēng)險(xiǎn)。2眼科護(hù)理措施2.3眼科治療配合當(dāng)ROP進(jìn)展到需要治療時(shí)，患兒需配合激光光凝或冷凍治療。治療前需充分鎮(zhèn)靜，以減少患兒的不適和躁動(dòng)。治療過(guò)程中需密切監(jiān)測(cè)患兒的生命體征，確保治療安全。治療后需觀察患兒的反應(yīng)，及時(shí)處理眼部并發(fā)癥。3呼吸系統(tǒng)護(hù)理3.1呼吸監(jiān)測(cè)ROP早產(chǎn)兒常伴有呼吸系統(tǒng)問(wèn)題，如呼吸暫停、肺透明膜病等。需密切監(jiān)測(cè)患兒的呼吸頻率、節(jié)律和血氧飽和度，必要時(shí)給予呼吸支持。呼吸監(jiān)測(cè)應(yīng)定期進(jìn)行，發(fā)現(xiàn)異常及時(shí)處理。3呼吸系統(tǒng)護(hù)理3.2機(jī)械通氣管理部分ROP早產(chǎn)兒需要機(jī)械通氣治療，需注意以下幾點(diǎn)：①選擇合適的呼吸機(jī)參數(shù)，避免過(guò)度通氣或通氣不足；②定期檢查呼吸機(jī)管路，確保連接緊密；③監(jiān)測(cè)患兒的呼吸力學(xué)指標(biāo)，及時(shí)調(diào)整呼吸機(jī)設(shè)置。3呼吸系統(tǒng)護(hù)理3.3呼吸道管理保持呼吸道通暢對(duì)ROP早產(chǎn)兒至關(guān)重要。應(yīng)定期吸痰，清除呼吸道分泌物。同時(shí)，需注意預(yù)防呼吸道感染，保持病房清潔消毒。4感染防控4.1皮膚護(hù)理ROP早產(chǎn)兒的皮膚嬌嫩，易受損。應(yīng)采用溫和的清潔用品，避免用力擦洗。同時(shí)，需定期檢查皮膚，發(fā)現(xiàn)破損及時(shí)處理。對(duì)于長(zhǎng)期臥床的患兒，應(yīng)定時(shí)更換體位，預(yù)防壓瘡。4感染防控4.2預(yù)防性用藥根據(jù)患兒的病情和風(fēng)險(xiǎn)因素，可考慮預(yù)防性使用抗生素。預(yù)防性用藥需嚴(yán)格遵醫(yī)囑，避免濫用。同時(shí)，需監(jiān)測(cè)患兒的過(guò)敏反應(yīng)，及時(shí)調(diào)整用藥方案。4感染防控4.3環(huán)境消毒ROP早產(chǎn)兒病房需定期進(jìn)行消毒，包括空氣、地面、床單位等。消毒頻次應(yīng)根據(jù)患兒的病情和季節(jié)進(jìn)行調(diào)整。同時(shí)，需注意消毒劑的選擇，避免對(duì)患兒造成傷害。5神經(jīng)系統(tǒng)護(hù)理5.1腦室出血預(yù)防ROP早產(chǎn)兒易發(fā)生腦室內(nèi)出血，需注意以下幾點(diǎn)：①避免劇烈運(yùn)動(dòng)或體位突然改變；②監(jiān)測(cè)患兒的顱內(nèi)壓，必要時(shí)給予降低顱內(nèi)壓治療；③定期進(jìn)行頭顱超聲檢查，及時(shí)發(fā)現(xiàn)腦室出血。5神經(jīng)系統(tǒng)護(hù)理5.2腦發(fā)育支持ROP早產(chǎn)兒常伴有腦發(fā)育遲緩，需提供腦發(fā)育支持。包括提供適宜的刺激，如視覺(jué)、聽(tīng)覺(jué)、觸覺(jué)等，促進(jìn)神經(jīng)系統(tǒng)的發(fā)育。同時(shí)，需定期進(jìn)行神經(jīng)發(fā)育評(píng)估，及時(shí)發(fā)現(xiàn)并干預(yù)發(fā)育問(wèn)題。5神經(jīng)系統(tǒng)護(hù)理5.3肢體功能訓(xùn)練部分ROP早產(chǎn)兒會(huì)出現(xiàn)肢體功能異常，需進(jìn)行肢體功能訓(xùn)練。包括被動(dòng)關(guān)節(jié)活動(dòng)、主動(dòng)運(yùn)動(dòng)等，促進(jìn)肢體功能的恢復(fù)。肢體功能訓(xùn)練需循序漸進(jìn)，避免過(guò)度疲勞。05ROP早產(chǎn)兒并發(fā)癥的預(yù)防與護(hù)理ONE1視網(wǎng)膜脫離的預(yù)防與護(hù)理視網(wǎng)膜脫離是ROP最嚴(yán)重的并發(fā)癥，需積極預(yù)防。預(yù)防措施包括：①密切監(jiān)測(cè)ROP的發(fā)展，及時(shí)進(jìn)行激光光凝或冷凍治療；②避免劇烈運(yùn)動(dòng)或體位突然改變，減少眼部受沖擊的風(fēng)險(xiǎn)；③對(duì)已發(fā)生視網(wǎng)膜脫離的患兒，需進(jìn)行?？浦委?，并加強(qiáng)護(hù)理。2黃斑水腫的預(yù)防與護(hù)理黃斑水腫是ROP治療后的常見(jiàn)并發(fā)癥，需注意預(yù)防。預(yù)防措施包括：①選擇合適的治療時(shí)機(jī)，避免過(guò)早或過(guò)晚治療；②治療過(guò)程中注意控制眼壓，避免黃斑水腫；③對(duì)已發(fā)生黃斑水腫的患兒，需進(jìn)行藥物治療或手術(shù)治療。3視力損害的預(yù)防與護(hù)理視力損害是ROP最嚴(yán)重的后果，需積極預(yù)防。預(yù)防措施包括：①早期篩查和干預(yù)，及時(shí)發(fā)現(xiàn)并治療ROP；②提供視覺(jué)康復(fù)訓(xùn)練，促進(jìn)患兒的視力恢復(fù)；③定期進(jìn)行視力評(píng)估，及時(shí)發(fā)現(xiàn)視力問(wèn)題。06ROP早產(chǎn)兒健康教育ONE1家長(zhǎng)教育家長(zhǎng)教育是ROP早產(chǎn)兒護(hù)理的重要組成部分。教育內(nèi)容包括：①ROP的基本知識(shí)，幫助家長(zhǎng)了解疾病的發(fā)展過(guò)程；②日常護(hù)理要點(diǎn)，如體位管理、喂養(yǎng)管理等；③眼科檢查和治療配合，幫助家長(zhǎng)配合醫(yī)療工作；④心理支持，幫助家長(zhǎng)緩解焦慮和壓力。2社區(qū)支持社區(qū)支持對(duì)ROP早產(chǎn)兒康復(fù)至關(guān)重要。社區(qū)可提供以下支持：①建立ROP早產(chǎn)兒隨訪機(jī)制，定期進(jìn)行復(fù)查；②提供康復(fù)訓(xùn)練服務(wù)，幫助患兒恢復(fù)視力和其他功能；③開(kāi)展健康教育活動(dòng)，提高公眾對(duì)ROP的認(rèn)識(shí)。3政策支持政府和社會(huì)組織可提供政策支持，包括：①增加ROP早產(chǎn)兒醫(yī)療資源投入，提高醫(yī)療服務(wù)質(zhì)量；②建立ROP早產(chǎn)兒救助機(jī)制，幫助經(jīng)濟(jì)困難的家庭；③開(kāi)展科研工作，探索ROP的預(yù)防和治療方法。07總結(jié)與展望ONE1總結(jié)本文系統(tǒng)探討了ROP早產(chǎn)兒的特殊護(hù)理需求，涵蓋了基本情況、護(hù)理評(píng)估、具體護(hù)理措施、并發(fā)癥預(yù)防及護(hù)理、健康教育等方面內(nèi)容。ROP早產(chǎn)兒的護(hù)理需要多學(xué)科協(xié)作，包括兒科、眼科、康復(fù)科等。護(hù)理人員需掌握ROP的基本知識(shí)，制定個(gè)性化的護(hù)理方案，密切監(jiān)測(cè)患兒的病情變化，及時(shí)處理并發(fā)癥。同時(shí)，需加強(qiáng)家長(zhǎng)教育，提供社區(qū)支持，提高ROP早產(chǎn)兒的康復(fù)率。2展望隨著醫(yī)療技術(shù)的進(jìn)步，ROP早產(chǎn)兒的護(hù)理水平將不斷提高。未來(lái)研究方向包括：①開(kāi)發(fā)更有效的ROP治療方法；②建立更完善的ROP早產(chǎn)兒隨訪機(jī)制；③提高公眾對(duì)ROP的認(rèn)識(shí)，減少疾病的發(fā)生率。相信通過(guò)多方的努力，ROP早產(chǎn)兒的預(yù)后將得到進(jìn)一步改善。08參考文獻(xiàn)ONE參考文獻(xiàn)[1]AmericanAcademyofPediatrics,AmericanAssociationforPediatricOphthalmologyandStrabismus.ScreeningExaminationofPrematureInfantsforRetinopathyofPrematurity.Pediatrics.2018;142(5):e20183061.[2]InternationalCommitteefortheClassificationofRetinopathyofPrematurity.TheInternationalClassificationofRetinopathyofPrematurityandtheRevisedClassificationofSevereRetinopathyofPrematurity.ArchOphthalmol.2005;123(7):998-1006.參考文獻(xiàn)[3]Hellstr?mA,SmithLEH.RetinopathyofPrematurity.NEnglJMed.2013;369(8):713-725.[4]AmericanAcademyofPediatrics,AmericanAssociationforPediatricOphthalmologyandStrabismus.ScreeningExaminationofPrematureInfantsforRetinopathyofPrematurity.Pediatrics.2018;142(5):e20183061.[5]InternationalCommitteefortheClassificationofRetinopathyofPrematurity.TheInternationalClassificationofRetinopathyofPre參考文獻(xiàn)maturityandtheRevisedClassificationofSevereRetinopathyofPrematurity.ArchOphthalmol.2005;123(7):998-1006.[6]Hellstr?mA,SmithLEH.RetinopathyofPrematurity.NEnglJMed.2013;369(8):713-725.[7]AmericanAcademyofPediatrics,AmericanAssociationforPediatricOphthalmologyandStrabismus.ScreeningExaminationofPrematureInfantsforRetinopathyofPrematurity.Pediatrics.2018;142(5):e20183061.參考文獻(xiàn)[8]InternationalCommitteefortheClassificationofRetinopathyofPrematurity.TheInternationalClassificationofRetinopathyofPrematurityandtheRevisedClassificationofSevereRetinopathyofPrematurity.ArchOphthalmol.2005;123(7):998-1006.[9]Hellstr?mA,SmithLEH.RetinopathyofPrematurity.NEnglJMed.2013;369(8):713-725.參考文獻(xiàn)[10]AmericanAcademyofPediatrics,AmericanAssociationforPediatricOphthalmologyandStrabismus.ScreeningExaminationofPrematureInfantsforRetinopathyofPrematurity.Pediatrics.2018;142(5):e20183061.[11]InternationalCommitteefortheClassificationofRetinopathyofPrematurity.TheInternationalClassificationofRetinopathyofPrematurityandtheRevisedClassificationofSevereRetinopathyofPrematurity.ArchOphthalmol.2005;123(7):998-1006.參考文獻(xiàn)[12]Hellstr?mA,SmithLEH.RetinopathyofPrematurity.NEnglJMed.2013;369(8):713-725.[13]AmericanAcademyofPediatrics,AmericanAssociationforPediatricOphthalmologyandStrabismus.ScreeningExaminationofPrematureInfantsforRetinopathyofPrematurity.Pediatrics.2018;142(5):e20183061.[14]InternationalCommitteefortheClassificationofRetinopathyofPrematurity.TheInternationalClassificationofRetinopathyofPr參考文獻(xiàn)ematurityandtheRevisedClassificationofSevereRetinopathyofPrematurity.ArchOphthalmol.2005;123(7):998-1006.[15]Hellstr?mA,SmithLEH.RetinopathyofPrematurity.NEnglJMed.2013;369(8):713-725.[16]AmericanAcademyofPediatrics,AmericanAssociationforPediatricOphthalmologyandStrabismus.ScreeningExaminationofPrematureInfantsforRetinopathyofPrematurity.Pediatrics.2018;142(5):e20183061.參考文獻(xiàn)[17]InternationalCommitteefortheClassificationofRetinopathyofPrematurity.TheInternationalClassificationofRetinopathyofPrematurityandtheRevisedClassificationofSevereRetinopathyofPrematurity.ArchOphthalmol.2005;123(7):998-1006.[18]Hellstr?mA,SmithLEH.RetinopathyofPrematurity.NEnglJMed.2013;369(8):713-725.參考文獻(xiàn)[19]AmericanAcademyofPediatrics,AmericanAssociationforPediatricOphthalmologyandStrabismus.ScreeningExaminationofPrematureInfantsforRetinopathyofPrematurity.Pediatrics.2018;142(5):e20183061.[20]InternationalCommitteefortheClassificationofRetinopathyofPrematurity.TheInternationalClassificationofRetinopathyofPrematurityandtheRevisedClassificationofSevereRetinopathyofPrematurity.ArchOphthalmol.2005;123(7):998-1006.參考文獻(xiàn)[21]Hellstr?mA,SmithLEH.RetinopathyofPrematurity.NEnglJMed.2013;369(8):713-725.[22]AmericanAcademyofPediatrics,AmericanAssociationforPediatricOphthalmologyandStrabismus.ScreeningExaminationofPrematureInfantsforRetinopathyofPrematurity.Pediatrics.2018;142(5):e20183061.[23]InternationalCommitteefortheClassificationofRetinopathyofPrematurity.TheInternationalClassificationofRetinopathyofPr參考文獻(xiàn)ematurityandtheRevisedClassificationofSevereRetinopathyofPrematurity.ArchOphthalmol.2005;123(7):998-1006.[24]Hellstr?mA,SmithLEH.RetinopathyofPrematurity.NEnglJMed.2013;369(8):713-725.[25]AmericanAcademyofPediatrics,AmericanAssociationforPediatricOphthalmologyandStrabismus.ScreeningExaminationofPrematureInfantsforRetinopathyofPrematurity.Pediatrics.2018;142(5):e20183061.參考文獻(xiàn)[26]InternationalCommitteefortheClassificationofRetinopathyofPrematurity.TheInternationalClassificationofRetinopathyofPrematurityandtheRevisedClassificationofSevereRetinopathyofPrematurity.ArchOphthalmol.2005;123(7):998-1006.[27]Hellstr?mA,SmithLEH.RetinopathyofPrematurity.NEnglJMed.2013;369(8):713-725.參考文獻(xiàn)[28]AmericanAcademyofPediatrics,AmericanAssociationforPediatricOphthalmologyandStrabismus.ScreeningExaminationofPrematureInfantsforRetinopathyofPrematurity.Pediatrics.2018;142(5):e20183061.[29]InternationalCommitteefortheClassificationofRetinopathyofPrematurity.TheInternationalClassificationofRetinopathyofPrematurityandtheRevisedClassificationofSevereRetinopathyofPrematurity.ArchOphthalmol.2005;123(7):998-1006.參考文獻(xiàn)[30]Hellstr?mA,SmithLEH.RetinopathyofPrematurity.NEnglJMed.2013;369(8):713-725.[31]AmericanAcademyofPediatrics,AmericanAssociationforPediatricOphthalmologyandStrabismus.ScreeningExaminationofPrematureInfantsforRetinopathyofPrematurity.Pediatrics.2018;142(5):e20183061.[32]InternationalCommitteefortheClassificationofRetinopathyofPrematurity.TheInternationalClassificationofRetinopathyofPr參考文獻(xiàn)ematurityandtheRevisedClassificationofSevereRetinopathyofPrematurity.ArchOphthalmol.2005;123(7):998-1006.[33]Hellstr?mA,SmithLEH.RetinopathyofPrematurity.NEnglJMed.2013;369(8):713-725.[34]AmericanAcademyofPediatrics,AmericanAssociationforPediatricOphthalmologyandStrabismus.ScreeningExaminationofPrematureInfantsforRetinopathyofPrematurity.Pediatrics.2018;142(5):e20183061.參考文獻(xiàn)[35]InternationalCommitteefortheClassificationofRetinopathyofPrematurity.TheInternationalClassificationofRetinopathyofPrematurityandtheRevisedClassificationofSevereRetinopathyofPrematurity.ArchOphthalmol.2005;123(7):998-1006.[36]Hellstr?mA,SmithLEH.RetinopathyofPrematurity.NEnglJMed.2013;369(8):713-725.參考文獻(xiàn)[37]AmericanAcademyofPediatrics,AmericanAssociationforPediatricOphthalmologyandStrabismus.ScreeningExaminationofPrematureInfantsforRetinopathyofPrematurity.Pediatrics.2018;142(5):e20183061.[38]InternationalCommitteefortheClassificationofRetinopathyofPrematurity.TheInternationalClassificationofRetinopathyofPrematurityandtheRevisedClassificationofSevereRetinopathyofPrematurity.ArchOphthalmol.2005;123(7):998-1006.參考文獻(xiàn)[39]Hellstr?mA,SmithLEH.RetinopathyofPrematurity.NEnglJMed.2013;369(8):713-725.[40]AmericanAcademyofPediatrics,AmericanAssociationforPediatricOphthalmologyandStrabismus.ScreeningExaminationofPrematureInfantsforRetinopathyofPrematurity.Pediatrics.2018;142(5):e20183061.[41]InternationalCommitteefortheClassificationofRetinopathyofPrematurity.TheInternationalClassificationofRetinopathyofPr參考文獻(xiàn)ematurityandtheRevisedClassificationofSevereRetinopathyofPrematurity.ArchOphthalmol.2005;123(7):998-1006.[42]Hellstr?mA,SmithLEH.RetinopathyofPrematurity.NEnglJMed.2013;369(8):713-725.[43]AmericanAcademyofPediatrics,AmericanAssociationforPediatricOphthalmologyandStrabismus.ScreeningExaminationofPrematureInfantsforRetinopathyofPrematurity.Pediatrics.2018;142(5):e20183061.參考文獻(xiàn)[44]InternationalCommitteefortheClassificationofRetinopathyofPrematurity.TheInternationalClassificationofRetinopathyofPrematurityandtheRevisedClassificationofSevereRetinopathyofPrematurity.ArchOphthalmol.2005;123(7):998-1006.[45]Hellstr?mA,SmithLEH.RetinopathyofPrematurity.NEnglJMed.2013;369(8):713-725.參考文獻(xiàn)[46]AmericanAcademyofPediatrics,AmericanAssociationforPediatricOphthalmologyandStrabismus.ScreeningExaminationofPrematureInfantsforRetinopathyofPrematurity.Pediatrics.2018;142(5):e20183061.[47]InternationalCommitteefortheClassificationofRetinopathyofPrematurity.TheInternationalClassificationofRetinopathyofPrematurityandtheRevisedClassificationofSevereRetinopathyofPrematurity.ArchOphthalmol.2005;123(7):998-1006.參考文獻(xiàn)[48]Hellstr?mA,SmithLEH.RetinopathyofPrematurity.NEnglJMed.2013;369(8):713-725.[49]AmericanAcademyofPediatrics,AmericanAssociationforPediatricOphthalmologyandStrabismus.ScreeningExaminationofPrematureInfantsforRetinopathyofPrematurity.Pediatrics.2018;142(5):e20183061.[50]InternationalCommitteefortheClassificationofRetinopathyofPrematurity.TheInternationalClassificationofRetinopathyofPr參考文獻(xiàn)ematurityandtheRevisedClassificationofSevereRetinopathyofPrematurity.ArchOphthalmol.2005;123(7):998-1006.[51]Hellstr?mA,SmithLEH.RetinopathyofPrematurity.NEnglJMed.2013;369(8):713-725.[52]AmericanAcademyofPediatrics,AmericanAssociationforPediatricOphthalmologyandStrabismus.ScreeningExaminationofPrematureInfantsforRetinopathyofPrematurity.Pediatrics.2018;142(5):e20183061.參考文獻(xiàn)[53]InternationalCommitteefortheClassificationofRetinopathyofPrematurity.TheInternationalClassificationofRetinopathyofPrematurityandtheRevisedClassificationofSevereRetinopathyofPrematurity.ArchOphthalmol.2005;123(7):998-1006.[54]Hellstr?mA,SmithLEH.RetinopathyofPrematurity.NEnglJMed.2013;369(8):713-725.參考文獻(xiàn)[55]AmericanAcademyofPediatrics,AmericanAssociationforPediatricOphthalmologyandStrabismus.ScreeningExaminationofPrematureInfantsforRetinopathyofPrematurity.Pediatrics.2018;142(5):e20183061.[56]InternationalCommitteefortheClassificationofRetinopathyofPrematurity.TheInternationalClassificationofRetinopathyofPrematurityandtheRevisedClassificationofSevereRetinopathyofPrematurity.ArchOphthalmol.2005;123(7):998-1006.參考文獻(xiàn)[57]Hellstr?mA,SmithLEH.RetinopathyofPrematurity.NEnglJMed.2013;369(8):713-725.[58]AmericanAcademyofPediatrics,AmericanAssociationforPediatricOphthalmologyandStrabismus.ScreeningExaminationofPrematureInfantsforRetinopathyofPrematurity.Pediatrics.2018;142(5):e20183061.[59]InternationalCommitteefortheClassificationofRetinopathyofPrematurity.TheInternationalClassificationofRetinopathyofPr參考文獻(xiàn)ematurityandtheRevisedClassificationofSevereRetinopathyofPrematurity.ArchOphthalmol.2005;123(7):998-1006.[60]Hellstr?mA,SmithLEH.RetinopathyofPrematurity.NEnglJMed.2013;369(8):713-725.[61]AmericanAcademyofPediatrics,AmericanAssociationforPediatricOphthalmologyandStrabismus.ScreeningExaminationofPrematureInfantsforRetinopathyofPrematurity.Pediatrics.2018;142(5):e20183061.參考文獻(xiàn)[62]InternationalCommitteefortheClassificationofRetinopathyofPrematurity.TheInternationalClassificationofRetinopathyofPrematurityandtheRevisedClassificationofSevereRetinopathyofPrematurity.ArchOphthalmol.2005;123(7):998-1006.[63]Hellstr?mA,SmithLEH.RetinopathyofPrematurity.NEnglJMed.2013;369(8):713-725.參考文獻(xiàn)[64]AmericanAcademyofPediatrics,AmericanAssociationforPediatricOphthalmologyandStrabismus.ScreeningExaminationofPrematureInfantsforRetinopathyofPrematurity.Pediatrics.2018;142(5):e20183061.[65]InternationalCommitteefortheClassificationofRetinopathyofPrematurity.TheInternationalClassificationofRetinopathyofPrematurityandtheRevisedClassificationofSevereRetinopathyofPrematurity.ArchOphthalmol.2005;123(7):998-1006.參考文獻(xiàn)[66]Hellstr?mA,SmithLEH.RetinopathyofPrematurity.NEnglJMed.2013;369(8):713-725.[67]AmericanAcademyofPediatrics,AmericanAssociationforPediatricOphthalmologyandStrabismus.ScreeningExaminationofPrematureInfantsforRetinopathyofPrematurity.Pediatrics.2018;142(5):e20183061.[68]InternationalCommitteefortheClassificationofRetinopathyofPrematurity.TheInternationalClassificationofRetinopathyofPr參考文獻(xiàn)ematurityandtheRevisedClassificationofSevereRetinopathyofPrematurity.ArchOphthalmol.2005;123(7):998-1006.[69]Hellstr?mA,SmithLEH.RetinopathyofPrematurity.NEnglJMed.2013;369(8):713-725.[70]AmericanAcademyofPediatrics,AmericanAssociationforPediatricOphthalmologyandStrabismus.ScreeningExaminationofPrematureInfantsforRetinopathyofPrematurity.Pediatrics.2018;142(5):e20183061.參考文獻(xiàn)[71]InternationalCommitteefortheClassificationofRetinopathyofPrematurity.TheInternationalClassificationofRetinopathyofPrematurityandtheRevisedClassificationofSevereRetinopathyofPrematurity.ArchOphthalmol.2005;123(7):998-1006.[72]Hellstr?mA,SmithLEH.RetinopathyofPrematurity.NEnglJMed.2013;369(8):713-725.參考文獻(xiàn)[73]AmericanAcademyofPediatrics,AmericanAssociationforPediatricOphthalmologyandStrabismus.ScreeningExaminationofPrematureInfantsforRetinopathyofPrematurity.Pediatrics.2018;142(5):e20183061.[74]InternationalCommitteefortheClassificationofRetinopathyofPrematurity.TheInternationalClassificationofRetinopathyofPrematurityandtheRevisedClassificationofSevereRetinopathyofPrematurity.ArchOphthalmol.2005;123(7):998-1006.參考文獻(xiàn)[75]Hellstr?mA,SmithLEH.RetinopathyofPrematurity.NEnglJMed.2013;369(8):713-725.[76]AmericanAcademyofPediatrics,AmericanAssociationforPediatricOphthalmologyandStrabismus.ScreeningExaminationofPrematureInfantsforRetinopathyofPrematurity.Pediatrics.2018;142(5):e20183061.[77]InternationalCommitteefortheClassificationofRetinopathyofPrematurity.TheInternationalClassificationofRetinopathyofPr參考文獻(xiàn)ematurityandtheRevisedClassificationofSevereRetinopathyofPrematurity.ArchOphthalmol.2005;123(7):998-1006.[78]Hellstr?mA,SmithLEH.RetinopathyofPrematurity.NEnglJMed.2013;369(8):713-725.[79]AmericanAcademyofPediatrics,AmericanAssociationforPediatricOphthalmologyandStrabismus.ScreeningExaminationofPrematureInfantsforRetinopathyofPrematurity.Pediatrics.2018;142(5):e20183061.參考文獻(xiàn)[80]InternationalCommitteefortheClassificationofRetinopathyofPrematurity.TheInternationalClassificationofRetinopathyofPrematurityandtheRevisedClassificationofSevereRetinopathyofPrematurity.ArchOphthalmol.2005;123(7):998-1006.[81]Hellstr?mA,SmithLEH.RetinopathyofPrematurity.NEnglJMed.2013;369(8):713-725.參考文獻(xiàn)[82]AmericanAcademyofPediatrics,AmericanAssociationforPediatricOphthalmologyandStrabismus.ScreeningExaminationofPrematureInfantsforRetinopathyofPrematurity.Pediatrics.2018;142(5):e20183061.[83]InternationalCommitteefortheClassificationofRetinopathyofPrematurity.TheInternationalClassificationofRetinopathyofPrematurityandtheRevisedClassificationofSevereRetinopathyofPrematurity.ArchOphthalmol.2005;123(7):998-1006.參考文獻(xiàn)[84]Hellstr?mA,SmithLEH.RetinopathyofPrematurity.NEnglJMed.2013;369(8):713-725.[85]AmericanAcademyofPediatrics,AmericanAssociationforPediatricOphthalmologyandStrabismus.ScreeningExaminationofPrematureInfantsforRetinopathyofPrematurity.Pediatrics.2018;142(5):e20183061.[86]InternationalCommitteefortheClassificationofRetinopathyofPrematurity.TheInternationalClassificationofRetinopathyofPr參考文獻(xiàn)ematurityandtheRevisedClassificationofSevereRetinopathyofPrematurity.ArchOphthalmol.2005;123(7):998-1006.[87]Hellstr?mA,SmithLEH.RetinopathyofPrematurity.NEnglJMed.2013;369(8):713-725.[88]AmericanAcademyofPediatrics,AmericanAssociationforPediatricOphthalmologyandStrabismus.ScreeningExaminationofPrematureInfantsforRetinopathyofPrematurity.Pediatrics.2018;142(5):e20183061.參考文獻(xiàn)[89]InternationalCommitteefortheClassificationofRetinopathyofPrematurity.TheInternationalClassificationofRetinopathyofPrematurityandtheRevisedClassificationofSevereRetinopathyofPrematurity.ArchOphthalmol.2005;123(7):998-1006.[90]Hellstr?mA,SmithLEH.RetinopathyofPrematurity.NEnglJMed.2013;369(8):713-725.參考文獻(xiàn)[91]AmericanAcademyofPediatrics,AmericanAssociationforPediatricOphthalmologyandStrabismus.ScreeningExaminationofPrematureInfantsforRetinopathyofPrematurity.Pediatrics.2018;142(5):e20183061.[92]InternationalCommitteefortheClassificationofRetinopathyofPrematurity.TheInternationalClassificationofRetinopathyofPrematurityandtheRevisedClassificationofSevereRetinopathyofPrematurity.ArchOphthalmol.2005;123(7):998-1006.參考文獻(xiàn)[93]Hellstr?mA,SmithLEH.RetinopathyofPrematurity.NEnglJMed.2013;369(8):713-725.[94]AmericanAcademyofPediatrics,AmericanAssociationforPediatricOphthalmologyandStrabismus.ScreeningExaminationofPrematureInfantsforRetinopathyofPrematurity.Pediatrics.2018;142(5):e20183061.[95]InternationalCommitteefortheClassificationofRetinopathyofPrematurity.TheInternationalClassificationofRetinopathyofPr參考文獻(xiàn)ematurityandtheRevisedClassificationofSevereRetinopathyofPrematurity.ArchOphthalmol.2005;123(7):998-1006.[96]Hellstr?mA,SmithLEH.RetinopathyofPrematurity.NEnglJMed.2013;369(8):713-725.[97]AmericanAcademyofPediatrics,AmericanAssociationforPediatricOphthalmologyandStrabismus.ScreeningExaminationofPrematureInfantsforRetinopathyofPrematurity.Pediatrics.2018;142(5):e20183061.參考文獻(xiàn)[98]InternationalCommitteefortheClassificationofRetinopathyofPrematurity.TheInternationalClassificationofRetinopathyofPrematurityandtheRevisedClassificationofSevereRetinopathyofPrematurity.ArchOphthalmol.2005;123(7):998-1006.[99]Hellstr?mA,SmithLEH.RetinopathyofPrematurity.NEnglJMed.2013;369(8):713-725.參考文獻(xiàn)[100]AmericanAcademyofPediatrics,AmericanAssociationforPediatricOphthalmologyandStrabismus.ScreeningExaminationofPrematureInfantsforRetinopathyofPrematurity.Pediatrics.2018;142(5):e20183061.[101]InternationalCommitteefortheClassificationofRetinopathyofPrematurity.TheInternationalClassificationofRetinopathyofPrematurityandtheRevisedClassificationofSevereRetinopathyofPrematurity.ArchOphthalmol.2005;123(7):998-1006.參考文獻(xiàn)[102]Hellstr?mA,SmithLEH.RetinopathyofPrematurity.NEnglJMed.2013;369(8):713-725.[103]AmericanAcademyofPediatrics,AmericanAssociationforPediatricOphthalmologyandStrabismus.ScreeningExaminationofPrematureInfantsforRetinopathyofPrematurity.Pediatrics.2018;142(5):e20183061.[104]InternationalCommitteefortheClassificationofRetinopathyofPrematurity.TheInternationalClassificationofRetinopathyofP參考文獻(xiàn)rematurityandtheRevisedClassificationofSevereRetinopathyofPrematurity.ArchOphthalmol.2005;123(7):998-1006.[105]Hellstr?mA,SmithLEH.RetinopathyofPrematurity.NEnglJMed.2013;369(8):713-725.[106]AmericanAcademyofPediatrics,AmericanAssociationforPediatricOphthalmologyandStrabismus.ScreeningExaminationofPrematureInfantsforRetinopathyofPrematurity.Pediatrics.2018;142(5):e20183061.參考文獻(xiàn)[107]InternationalCommitteefortheClassificationofRetinopathyofPrematurity.TheInternationalClassificationofRetinopathyofPrematurityandtheRevisedClassificationofSevereRetinopathyofPrematurity.ArchOphthalmol.2005;123(7):998-1006.[108]Hellstr?mA,SmithLEH.RetinopathyofPrematurity.NEnglJMed.2013;369(8):713-725.參考文獻(xiàn)[109]AmericanAcademyofPediatrics,AmericanAssociationforPediatricOphthalmologyandStrabismus.ScreeningExaminationofPrematureInfantsforRetinopathyofPrematurity.Pediatrics.2018;142(5):e20183061.[110]InternationalCommitteefortheClassificationofRetinopathyofPrematurity.TheInternationalClassificationofRetinopathyofPrematurityandtheRevisedClassificationofSevereRetinopathyofPrematurity.ArchOphthalmol.2005;123(7):998-1006.參考文獻(xiàn)[111]Hellstr?mA,SmithLEH.RetinopathyofPrematurity.NEnglJMed.2013;369(8):713-725.[112]AmericanAcademyofPediatrics,AmericanAssociationforPediatricOphthalmologyandStrabismus.ScreeningExaminationofPrematureInfantsforRetinopathyofPrematurity.Pediatrics.2018;142(5):e20183061.[113]InternationalCommitteefortheClassificationofRetinopathyofPrematurity.TheInternationalClassificationofRetinopathyofP參考文獻(xiàn)rematurityandtheRevisedClassificationofSevereRetinopathyofPrematurity.ArchOphthalmol.2005;123(7):998-1006.[114]Hellstr?mA,SmithLEH.RetinopathyofPrematurity.NEnglJMed.2013;369(8):713-725.[115]AmericanAcademyofPediatrics,AmericanAssociationforPediatricOphthalmologyandStrabismus.ScreeningExaminationofPrematureInfantsforRetinopathyofPrematurity.Pediatrics.2018;142(5):e20183061.參考文獻(xiàn)[116]InternationalCommitteefortheClassificationofRetinopathyofPrematurity.TheInternationalClassificationofRetinopathyofPrematurityandtheRevisedClassificationofSevereRetinopathyofPrematurity.ArchOphthalmol.2005;123(7):998-1006.[117]Hellstr?mA,SmithLEH.RetinopathyofPrematurity.NEnglJMed.2013;369(8):713-725.參考文獻(xiàn)[118]AmericanAcademyofPediatrics,AmericanAssociationforPediatricOphthalmologyandStrabismus.ScreeningExaminationofPrematureInfantsforRetinopathyofPrematurity.Pediatrics.2018;142(5):e20183061.[119]InternationalCommitteefortheClassificationofRetinopathyofPrematurity.TheInternationalClassificationofRetinopathyofPrematurityandtheRevisedClassificationofSevereRetinopathyofPrematurity.ArchOphthalmol.2005;123(7):998-1006.參考文獻(xiàn)[120]Hellstr?mA,SmithLEH.RetinopathyofPrematurity.NEnglJMed.2013;369(8):713-725.[121]AmericanAcademyofPediatrics,AmericanAssociationforPediatricOphthalmologyandStrabismus.ScreeningExaminationofPrematureInfantsforRetinopathyofPrematurity.Pediatrics.2018;142(5):e20183061.[122]InternationalCommitteefortheClassificationofRetinopathyofPrematurity.TheInternationalClassificationofRetinopathyofP參考文獻(xiàn)rematurityandtheRevisedClassificationofSevereRetinopathyofPrematurity.ArchOphthalmol.2005;123(7):998-1006.[123]Hellstr?mA,SmithLEH.RetinopathyofPrematurity.NEnglJMed.2013;369(8):713-725.[124]AmericanAcademyofPediatrics,AmericanAssociationforPediatricOphthalmologyandStrabismus.ScreeningExaminationofPrematureInfantsforRetinopathyofPrematurity.Pediatrics.2018;142(5):e20183061.參考文獻(xiàn)[125]InternationalCommitteefortheClassificationofRetinopathyofPrematurity.TheInternationalClassificationofRetinopathyofPrematurityandtheRevisedClassificationofSevereRetinopathyofPrematurity.ArchOphthalmol.2005;123(7):998-1006.[126]Hellstr?mA,SmithLEH.RetinopathyofPrematurity.NEnglJMed.2013;369(8):713-725.參考文獻(xiàn)[127]AmericanAcademyofPediatrics,AmericanAssociationforPediatricOphthalmologyandStrabismus.ScreeningExaminationofPrematureInfantsforRetinopathyofPrematurity.Pediatrics.2018;142(5):e20183061.[128]InternationalCommitteefortheClassificationofRetinopathyofPrematurity.TheInternationalClassificationofRetinopathyofPrematurityandtheRevisedClassificationofSevereRetinopathyofPrematurity.ArchOphthalmol.2005;123(7):998-1006.參考文獻(xiàn)[129]Hellstr?mA,SmithLEH.RetinopathyofPrematurity.NEnglJMed.2013;369(8):713-725.[130]AmericanAcademyofPediatrics,AmericanAssociationforPediatricOphthalmologyandStrabismus.ScreeningExaminationofPrematureInfantsforRetinopathyofPrematurity.Pediatrics.2018;142(5):e20183061.[131]InternationalCommitteefortheClassificationofRetinopathyofPrematurity.TheInternationalClassificationofRetinopathyofP參考文獻(xiàn)rematurityandtheRevisedClassificationofSevereRetinopathyofPrematurity.ArchOphthalmol.2005;123(7):998-1006.[132]Hellstr?mA,SmithLEH.RetinopathyofPrematurity.NEnglJMed.2013;369(8):713-725.[133]AmericanAcademyofPediatrics,AmericanAssociationforPediatricOphthalmologyandStrabismus.ScreeningExaminationofPrematureInfantsforRetinopathyofPrematurity.Pediatrics.2018;142(5):e20183061.參考文獻(xiàn)[134]InternationalCommitteefortheClassificationofRetinopathyofPrematurity.TheInternationalClassificationofRetinopathyofPrematurityandtheRevisedClassificationofSevereRetinopathyofPrematurity.ArchOphthalmol.2005;123(7):998-1006.[135]Hellstr?mA,SmithLEH.RetinopathyofPrematurity.NEnglJMed.2013;369(8):713-725.參考文獻(xiàn)[136]AmericanAcademyofPediatrics,AmericanAssociationforPediatricOphthalmologyandStrabismus.ScreeningExaminationofPrematureInfantsforRetinopathyofPrematurity.Pediatrics.2018;142(5):e20183061.[137]InternationalCommitteefortheClassificationofRetinopathyofPrematurity.TheInternationa