摘要
目的探讨妊娠梅毒患者临床特点、治疗方法和妊娠结局,以降低先天性梅毒发生率。方法170例经血清学检查确诊为梅毒的孕妇,根据妊娠期是否行全疗程抗梅毒治疗,分为治疗组(92例)和未治疗组(78例),选择同期正常孕妇为对照组(100例)。比较三组孕妇的妊娠结局,治疗组和未治疗组围产儿预后及新生儿先天梅毒的发生情况。结果①妊娠结局:治疗组足月分娩率为93.47%(86/92),未治疗组仅为30.76%(24/78),对照组为96.00%(96/100)。未治疗组与治疗组、对照组比较,差异有显著性(P<0.05)。治疗组早产及死胎发生率分别为6.52%(6/92)和2.17%(2/92),接近对照组的6.00%(6/100)、0,明显低于未治疗组的30.77%(24/78)、28.21%(22/78),差异有显著性(P<0.05)。治疗组窒息儿、低体重儿、先天梅毒患儿发生率及新生儿死亡率明显低于未治疗组,两组比较,差异有显著性(P<0.05)。治疗组分娩正常新生儿者占60.86%(56/92),未治疗组仅占25.64%(20/78)。②治疗孕周越早,先天梅毒患儿发生率越低(P<0.05)。先天梅毒患儿的发生率,应用苄星青霉素孕妇为23.07%(18/78),应用红霉素孕妇为100%(14/14)。③新生儿血清RPR阳性率治疗组为79.50%,未治疗组为100%,差异无显著意义。结论妊娠梅毒患者临床分期以潜伏期梅毒为主,体征及症状不典型,容易误诊。因此,妊娠早期常规梅毒筛查特别重要。治疗开始时的孕周及用药,是影响妊娠梅毒结局的重要因素。
Objective To investigate the clinical presentation and treatments in pregnant women with syphilis. The aim is to reduce the incidence of congenital syphilis. Method 170 pregnant women with syphilis by serological assays were divided into two groups, namely the treated groups [with a full course of anti-syphilis therapy （n=92）] and untreated group （n=78）. Control group included 100 normal pregnant women. The pregnant outcomes and newborn with congenital syphilis between these 2 groups were compared. Result ①Term delivery rate of treated and untreated group was 93.47% （86/92） and, 30.76% （24/78）, respectively. Term delivery rate of normal subjects in the control group was 96.00%（96/100）. The rates of premature birth （6.52%, 6/92） and fetal intrauterine death （2.17%） in the treated group were similar to the control group （6.00%,0）. The rates are obviously lower [30.77% （24/78） and 28.21% （22/78）] than the untreated group （P〈0.05）. The rates of asphyxia neonates, low birth weight, congenital syphilis and neonatal death in the treated group were significantly lower than those in the untreated group （P〈0.05）. 60.86% （56/92） of women in the treated group had normal neonates, and the percentage of normal neonates in the untreated group was 25.64% women （20/78）. ②Gestational week and treatment： Women with treatment during early gestation resulted in a lower the rate of congenital syphilis（P〈0.05）. ③The occurrence of RPR（＋） were similar between the treated and untreated group （P〉0.05）. Conclusion During pregnancy, syphilis is easy misdiagnosed as the symptom is mild. Routing screening of syphilis is essential for pregnant women. The starting time of treatment for syphilis and the choice of drugs may affect the outcomes of pregnancy.
出处
《热带医学杂志》
CAS
2006年第4期406-408,358,共4页
Journal of Tropical Medicine
关键词
梅毒
妊娠并发症
先天性
syphilis
pregnancy complication
congenital
