3个月以下幼婴先天梅毒121例临床分析  

Clinical features of 121 infants below 3 months of age with congenital syphilis

作　　者：沈辉君[1] 孙眉月[1] 刘爱民[1] 

机构地区：[1]浙江大学医学院附属儿童医院内科,310006

出　　处：《中华儿科杂志》2009年第11期871-873,共3页Chinese Journal of Pediatrics

摘　　要：目的为了解3个月以下幼婴先天性梅毒（cs）的临床特点及误诊情况。方法收集我院1997年1月-2007年5月确诊为先天性梅毒的3个月以下幼婴121例，将临床表现、实验室检查及治疗情况进行回顾性分析。结果3个月以下幼婴先天性梅毒的临床表现多样，累及皮肤、呼吸、消化、血液、神经、骨骼等多系统，121例中白细胞增高89．3％，皮肤损害59．5％，肝脏肿大56．2％，脾肿大41．3％，贫血38．8％，发热28．9％，病理性黄疸24．0％，出生后生长发育迟缓12．4％，骨骼损害54．3％等；误诊率17．4％，误诊疾病达10种。结论3个月以下幼婴先天性梅毒的临床表现复杂多变，缺乏特异性，易被误诊，需要临床医师提高警惕；恢复婚检，大力开展梅毒筛查以及加强流动人口的管理，对预防先天性梅毒的发生很有必要。Objective To investigate the clinical features and diagnosis of infants under 3 months of age with congenital syphilis. Method Data of 121 infants below 3 months of age with congenital syphilis were collected from January 1997 to May 2007 at the authors＇ hospital. Their clinical features, laboratory findings and treatment were reviewed. Result Clinical manifestations of congenital syphilis in the infants were diverse. The disease involved multiple systems such as the skin, respiratory, digestive, blood, and nervous system, skeleton and so on. Among the 121 infants, the manifestations included increased leukocyte count （ 89.3% ）, skin damage （59. 5% ）, hepatomegaly （56. 2% ）, sp]enomegaly （41.3%）, anemia （38.8%） , fever （28.9%）, pathologic jaundice （24. 0% ） , growth retardation after birth （ 12.4% ） and bone damage （54. 3% ）, etc. The rate of misdiagnosis was 17.4 percent, and the kinds of disease misdiagnosed were up to 10. Conclusion Clinical manifestations of congenital syphilis in infants under 3 months of age were complicated and nonspecific, therefore doctors misdiagnosed it very easily. Clinicians should attach great importance to it. At the same time, the restoration of antemarltal examination, vigorously carrying out screening for syphilis and strengthening the management of immigrants are necessary to prevent congenital syphilis.

关 键 词：梅毒 先天性 婴儿 临床 

分 类 号：R686[医药卫生—骨科学]