A COMPREHENSIVE APPROACH TO THE PREVENTION OF RETINOPATHY IN PREMATURE INFANTS

Gasimov E. M., Akperova A. T., Mammedzade G. T., Medjidova S. Z.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

Objective: to study the effectiveness of complex application of early nasal CPAP, instillation of dexamethasone and Emoxipine eye drops in premature infants with respiratory distress syndrome (RDS) for the prevention of retinopathy of prematurity (PH). Methods. 200 children born before the 31st week of pregnancy weighing less than 1200 grams were under observation. The minimum gestational age for children was 26 weeks and the maximum age was 31 weeks. All children received two-stage treatment in the intensive care unit. All infants received respiratory therapy SDPD (CPAP) (spontaneous breathing with continuous positive airway pressure). The patients were divided into 3 groups: the 1st group of 80 infants who received respiratory therapy according to the method of CPAP with variable flow (Infant flow driver – IFD). CPD IFD; 2nd group – 80 infants who received respiratory therapy by the method of Bubble CPAP; 3-I – 50 infants who received respiratory therapy by the method of artificial lung ventilation (ALV). In the first group, all patients (80 children, 160 eyes) were instilled eye drops of 1% solution of Emoxypine for 6 weeks, every 10 minutes for 1 hour, Dexamethasone three times a day. In group 2, all patients (80 children, 160 eyes) were instilled eye drops of 1% Emoxypine solution for 6 weeks, every 10 minutes for 1 hour, Dexamethasone is not prescribed. At the 3-Oh group in all patients (40 patients, 80 eyes) not carried out the instillation of eye drops. Results. The result of the study was evaluated on the basis of ophthalmological examinations: at the time of the first manifestation of the signs of the disease, the frequency of spread in groups, the spread of retinal zones, stages of development, the frequency of the appearance of the posterior aggressive form and regression. In the first group, PH was found in 29 (36%) children. The posterior aggressive PH was found in 1 (3.4%) child of group 1. Among children with PH, 19 of 29 children (65.5%) had regression, 10 (34,5%) were treated. There was no need for re-treatment. In group 2, all patients (80 children, 160 eyes) were instilled with eye drops of 1% solution of Emoxypine for 6 weeks, every 10 minutes for 1 hour, the drug Dexamethasone was not prescribed. In group 2, PH was found in 38 (47.5%) of 80 children. Posterior aggressive PH was found in 3 (7.9%) children. 18 (47.4%) children were treated, and 20 (52.6%) children had regression. Repeated therapy was performed in one of the children with aggressive PH. In the 3rd group all patients (40 patients, 80 eyes) not carried out the instillation of eye drops. In group 3, PH was found in 21 (52.5%) of 40 children. Posterior aggressive PH was found in 7 (7.9%) children. 17 (81%) children were treated, and 4 (19%) children had regression. Repeated therapy was performed in 3 children. 2 of these children were with back an aggressive form of PH. At first, an intravitreal administration of anti-VEGF injections was performed, and 1 week after progression, peripheral laser coagulation was performed. However, despite this, the total retinal detachment occurred in both eyes. Thus, comparing the results of the three groups, it seems that the cases of PH were least encountered in the first group. This influenced the later manifestation of his signs. The disease was most manifested by retinal perforation, regression was also more common, and there was no need for re-treatment. Conclusion. An integrated approach to the development of retinopathy of premature infants through early optimization of respiratory therapy with Emoxypine and Dexamethasone has a positive effect on the prevention of this disease.

retinopathy of prematurity, treatment, prevention, artificial ventilation

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«Bulletin of problems biology and medicine» Issue 2 (144), 2018 year, 150-154 pages, index UDK 617.735-002-053.32

10.29254/2077-4214-2018-2-144-150-154