新生儿先天梅毒临床分类及治疗探讨  

CLINICAL CLASSIFICATION AND THERAPEUTIC EXPLORATION EM NEONATAL CONGENITAL SYPHILIS

作　　者：陈涵强[1] 章丽燕[1] 

机构地区：[1]福建省妇幼保健院新生儿科,350001

出　　处：《新生儿科杂志》2002年第5期205-207,共3页The Journal of Neonatology

摘　　要：目的:探讨新生儿先天梅毒（CS）临床分类及治疗。方法:回顾性分析1996年7月至2000年12月我科收治的新生儿 CS 111例。结果:有临床表现的新生儿CS81例,临床表现复杂,多样化,累及多个脏器,依次为肢端掌趾脱皮、斑疹,肝脾肿大,低体重,呼吸困难,腹胀,梅毒性假麻痹、贫血、黄疸、血小板减少和水肿。梅毒血清学（RPR及TPHA）阳性。无临床表现30例,但梅毒血清学检查阳性。青霉素治疗有效,未发现不良反应。13例因不可逆的严重多脏器损害死亡。随访26例,体格发育无明显异常,血RPR6个月时转阴15/22例（68.1％）,12个月时转阴20/22例（90.9％）,TPHA12个月时转阴10/16例（62.5％）。结论:新生儿CS临床可分为二类,具有典型早期临床表现和无症状先天梅毒。诊断要依据临床表现、梅毒血清学检查及母梅毒病史。青霉素治疗有效。In order to explore the clinical classification and therapy in neonatal congenital syphilis. Methods the medical records of 111 cases of congenital syphilis admitted to the department of neonatology between Ju-ly, 1996 to December, 2000 were reviewed. Eighty neonates had clinical manifestations . They were desquamation of the skin affecting palms and soles,hepatosplenomegaly,low birth weight, respiratory distress, abdomen distension,pseudoparalysis,anaemia,jaundice,thrombocytopenia and edema. 30 cases had no clinical manifestations, but their RPR and TPHA were positive, they were mostly bom to mothers suffering syphilis at pregnancy and be treated.Treatment with benzyl-penicillin are effective. 15 cases died. The cause of death was the irreversible damage in organs. Follow up of 26 cases, their physical growth was normal. The negative conversion of RPR test and TPHA occured at 6 months and 12 months after treatment respectively. Conclusion: Neonatsl congenital syphilis can be divided into two category. The diagnosis must be according to the mother is history of syphilis suffering, the classical early clinical manifestations and positive serology of syphilis. The cases without clinical manifestations but positive serology are needed monitoring for 6 months to 12 months.Treatment with benzyl-penicillin are effective,no side-effect.

关 键 词：新生儿 先天性梅毒 分类 治疗 

分 类 号：R722.1[医药卫生—儿科]