目的 分析先天性梅毒新生儿的围产期情况、临床特点及治疗转归。方法 选取并回顾性分析2012-03至2022-05解放军总医院第五医学中心儿科确诊的15例新生儿先天性梅毒的病例资料。结果 15例先天性梅毒新生儿中胎龄32～36周9例(60.0%),胎龄37周以上6例(40.0%);出生体重小于2500 g 8例(53.3%)。先天性梅毒新生儿中母亲无业10例(66.7%),文化程度中学11例(73.3%),有11例(73.3%)母亲产前未产检及治疗。新生儿出现皮肤损害6例(40.0%);谷丙转氨酶增高6例(40.0%);直接胆红素增高5例(33.3.%);贫血9例(60.0%),血小板下降5例(33.3.%);肾病综合征3例(20.0%);肺炎4例(26.7%),白细胞增高6例(40.0%),C反应蛋白增高13例(83.7%);抽搐1例(6.7%);长骨拍片异常3例(20.0%)。结论 梅毒孕妇产前未规律产检及治疗是发生母婴传播的主要原因,故应加强孕期宣传及梅毒血清学检测;新生儿先天性梅毒的临床特征复杂多样,且无明显特异性,故对疑似新生儿应尽早行梅毒血清学检查,及时诊断、规范治疗,避免不良预后的发生。
Abstract
Objective To analyze the perinatal situation, clinical characteristics and treatment outcome of neonates with congenital syphilis.Methods The clinical data of 15 neonates with congenital syphilis admitted to the Department of Pediatrics of the Fifth Medical Center of Chinese PLA General Hospital from March 2012 to May 2022 were retrospectively analyzed.Results Among 15 neonates with congenital syphilis, the gestational age ranged from 32 to 36 weeks in 9 cases (60.0%) and over 37 weeks in 6 cases (40.0%), and eight cases (53.3%) had a birth weight less than 2500 grams. Among the mothers of the neonates with congenital syphilis, 10 people (66.7%) were unemployed, 11 persons (73.3%) had a middle school education, and 11 mothers (73.3%) did not have prenatal examination and treatment. Among the neonates, skin lesions occurred in 6 cases (40.0%), alanine aminotransferase increased in 6 cases (40.0%), direct bilirubin increase occurred in 5 cases (33.3%), nine cases (60.0%) had different degrees of anemia, 5 cases (33.3%) had thrombocytopenia., nephrotic syndrome occurred in 3 cases (20.0%). Pneumonia was diagnosed in 4 cases (26.7%), leukocyte increased in 6 cases (40.0%), C-reactive protein increased in 13 cases (83.7%), convulsions occurred in 1 case (6.7%), and 3 cases (20%) had abnormal long bone radiography.Conclusions The main cause of mother-to-child transmission of syphilis is the irregular prenatal examination and treatment of syphilis mothers, so it is necessary to strengthen the propaganda during pregnancy and syphilis serological testing. The clinical features of neonatal congenital syphilis are complex and diverse without obvious specificity, so suspected children should receive serological examination of syphilis as soon as possible, and timely diagnosis and standardized treatment will get good outcome.
关键词
新生儿梅毒 /
先天性梅毒 /
临床特征 /
妊娠梅毒 /
梅毒血清学指标
Key words
neonatal syphilis /
congenital syphilis /
clinical features /
syphilis of pregnancy /
serological index of syphilis
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