摘要
目的:探究梅毒早期诊断与干预对妊娠结局及新生儿影响。方法:回顾性收集2017年8月-2018年6月本院就诊的妊娠期并发梅毒患者154例临床资料,根据是否实施驱梅治疗分组,治疗组(孕早期49例)、孕中晚期(43例)实施干预治疗,对照组(62例)未实施干预治疗;对比分析妊娠结局与新生儿状况。结果:对照组足月新生儿(16.1%)、存活率(51.6%)均低于治疗组,早产(35.5%)、流产死胎畸胎(48.5%)发生率高于治疗组,孕早期治疗组流产死胎畸胎发生率(0.0%)低于观察组孕中晚期治疗组(9.3%)(均P<0.05)。在120例新生儿中,有43例(35.8%)新生儿出现先天性梅毒,孕早期组(3例,6.1%)低于孕中晚期(13例,33.3%)且均低于对照组(32例,84.4%)(P<0.05)。分娩前TRUST滴度≤1:4组正常新生儿比例(79.1%)高于TRUST滴度≥1:8组(13.2%),甲苯胺红不加热血清试验(TRUST)滴度≥1:8组先天性梅毒(50.0%)、流产死胎畸胎(42.7%)发生比例高于TRUST滴度≤1:4组(P<0.05)。新生儿1 min 5 min Apgar评分孕早期治疗组(8.38±0.40分、8.47±0.36分)高于孕中晚期治疗组(8.04±0.31分、8.14±0.32分),且均高于对照组(7.74±0.27分、7.86±0.28分)(P<0.05)。结论:妊娠合并梅毒患者早期干预治疗可有效改善妊娠结局,且孕早期干预效果优于孕中晚期。
Objective:To investigate the influence of early syphilis diagnose and intervention of pregnant women on their pregnancy outcomes and neonatal health.Methods:The clinical data of 154 pregnant women with syphilis from August 2017 to June 2018 were analyzed retrospectively,in which,49 women in group A were given treatment of syphilis during the first trimester pregnancy,43 women in group B were given treatment of syphilis during the third trimester pregnancy,and 62 women in group C were not given treatment of syphilis.The pregnancy outcomes and newborn health status of women were compared among the three groups.Results:The full-term newborn rate and survival rate of women in group C were 16.1%and 51.6%,which were significant lower than those of women in group A and B,but the incidences of premature delivery and aborted stillbirth of women in group C were 35.5%and 48.5%,which were significant higher than those of women in group A and B(P<0.05).The incidence of abortion and stillbirth of women in group A was 0.0%,which was significant lower than that(9.3%)of women in group B(P<0.05).Among the 120 newborns,there were 43(35.8%)newborns with congenital syphilis,which included 3 cases(6.1%)in group A,13 cases(33.3%)in group B,and 32 cases(84.4%)in group C,and there were significant different in the rate of newborns with congenital syphilis among the three groups(P<0.05).Before delivery,the proportions of normal newborns and newborns with congenital syphilis of women with the TRUST titer≤1:4 were 79.1%and 50.0%,which were significant higher than those(13.2%and 42.7%)of women with the TRUST titer≥1:8(P<0.05).The average Apgar score of 1 min and 5 min of newborns after born in group A were 8.38±0.40 scores and 8.47±0.36 scores,which were significant higher than those of newborns(8.04±0.31 scores and 8.14±0.32 scores)in group B,and those of newborns in group A and B were significant higher than those of newborns(7.74±0.27 scores and 7.86±0.28 scores)in group C(P<0.05).Conclusion:Early syphilis diagnose and intervention of pregnant women can effectively improve the their pregnancy outcomes,and the treatment effect of syphilis during the first trimester pregnancy is better than that during the second and third trimester pregnancy.
作者
饶燕
刘珊珊
王菲
RAO Yan;LIU Shanshan;WANG Fei(Anqing Hospital of People's Liberation Army Navy, Anhui Province,246003)
出处
《中国计划生育学杂志》
2020年第3期449-451,462,共4页
Chinese Journal of Family Planning
关键词
妊娠合并梅毒
孕早期干预
甲苯胺红不加热血清试验
妊娠结局
新生儿先天性梅毒
Pregnancy with syphilis
Early intervention
Toluidine red non-heating serum test
Pregnancy outcomes
Neonatal congenital syphilis
