梅毒早期诊断与干预对妊娠结局及新生儿影响  

The influence of early syphilis diagnose and intervention of pegnant women on their pregnancy outcomes and neonatal health

作　　者：饶燕[1] 刘珊珊 王菲[1] RAO Yan;LIU Shanshan;WANG Fei(Anqing Hospital of People's Liberation Army Navy, Anhui Province,246003)

机构地区：[1]中国人民解放军海军安庆医院,安庆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

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 intervent

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 

分 类 号：R759.15[医药卫生—皮肤病学与性病学]