| 152 | 5 | 221 |
| 下载次数 | 被引频次 | 阅读次数 |
目的了解成都市开展预防梅毒母婴传播工作所取得的成效,探讨不同的治疗情况对于妊娠合并梅毒患者妊娠结局的影响。方法对成都市2012年7月-2013年12月在成都市医疗机构收治并分娩的妊娠合并梅毒患者368例进行问卷调查并对其所生婴幼儿随访追踪。采用卡方分析研究不同的治疗情况对于妊娠合并梅毒患者妊娠结局的影响。结果 1完成295名妊娠梅毒患者的问卷调查及273名所生婴儿的追踪随访工作,其中22人出现流产/死胎或新生儿死亡,9例婴儿确诊为先天梅毒;规范驱梅治疗组不良妊娠结局(包括流产/死胎、新生儿死亡及婴儿确诊为先天梅毒)的比例为1.62%;未规范治疗组不良妊娠结局率为15.49%;未治疗组不良妊娠结局率为43.59%。2无论妊娠梅毒患者确诊时RPR/TRUST滴度水平如何,各妊娠结局在规范治疗组、不规范治疗组、未治疗组中的分布差异具有统计学意义(P<0.05)。结论针对妊娠梅毒患者开展规范治疗可以有效降低不良妊娠结局率,若无法进行规范治疗,在孕晚期进行治疗也能在一定程度上预防梅毒母婴传播。
Abstract：Objective To learn the effectiveness of mother-to-child transmission( PMTCT) of Syphilis in Chengdu,and explore the influence of pregnancy outcome in different antisyphilitic treatment for pregnant women with syphilis. Method Conducted questionnaires for 368 pregnant women with syphilis who admitted and giving birth in all health care institutions and follow-up tracking for their infants from 2012 July to 2013 December. Researched the influence of pregnancy outcome in different antisyphilitic treatment for pregnant women with syphilis by Chi-square analysis. Results 1Completed questionnaires for 295 pregnant patients with syphilis and follow-up tracking for their 273 infants,in which 22 people miscarriage / stillbirth or neonatal death,9 infants diagnosed with congenital syphilis,the rate of adverse pregnancy outcomes( Including miscarriage / stillbirth,neonatal death and infant diagnosed with congenital syphilis) in standard treatment group was 1. 62%,the rate in no standard treatment group was 15. 49%,the rate in untreated group was 15. 49%. 2Whatever the RPR / TRUST titer levels,the pregnancy outcome in the standard treatment group,the no standard treatment and the untreated group was statistically significant( P < 0. 05). Conclusion Stantard treatment can effectively reduce the rate of adverse pregnancy outcome. If you can not regulate the treatment,no standardized treatment can produce a certain effect in the late trimester of pregnancy.
[1]Sheffield JS,Sanchez PJ,Wendel GD.et al.Placental histopathology of congenital syphilis[J].Obstet Gynecol,2002,100:126-133.
[2]乐杰.妇产科学.7版.北京:人民卫生出版社,2008:165.
[3]Hawkes S,Matin N,Brontet N,et al.Effectiveness of interventions to improve screening for syphilis in pregnancy:a systematic review and meta-analysis[J].Lancet Infect Dis,2011,11(9):684-691.
[4]Chen XS,Peeling Rw,Yin YP,et al.Improving antenatal care to prevent adverse pregnancy outcomes caused by syphilis.Future Micmbiol,2011,6:1131-1134.
[5]王临虹,王玲,王爱玲,等.先天梅毒防治指南(二)[J].中国妇幼卫生杂志,2010,1(5):238-244.
[6]Vasquez-Manzanilla O,Dickson-Gonzalez SM,Salas JG,et al.Influence of mother VDRL titers on the outcome of newboms with congenitalsyphilis[J].Trop Biomed,2008,25(1):58-63.
[7]Goldenberg RL,Thompson C.The infectious origins of stillbirth[J].Am J Obstet Gynecol,2003,189(3):861-873.
[8]周敏,陈竹,曾义岚,等.抗梅毒治疗对妊娠结局及新生儿预后的影响[J].中华临床感染病杂志,2013,6(4):226-229.
[9]Herremans T,Kortbeek L,Notermans DW.A review of diagnostic tests for congenital syphilis in newborns[J].Clin Microbiol Infect Dis,20l0,29(5):495-501.
[10]Blencowe H,Cousens S,Kamb M,et al.Lives Saved Tool supplement detection and treatment of syphilis in pregnancy to reduce syphilis related stillbirths and neonatal mortality[J].BMC Public Health,2011,13:S9.
[11]许宗严,邱莉霞,李频,等.妊娠梅毒患者772例母婴梅毒传播阻断效果回顾性分析[J].中国皮肤性病学杂志[J].2012,26(8):720-722.
基本信息:
DOI：10.19757/j.cnki.issn1674-7763.2015.06.016
中图分类号:R759.15
引用信息:
[1]孔金旺,王燕,黄华敏,等.规范治疗对妊娠梅毒患者妊娠结局的影响分析[J].中国妇幼卫生杂志,2015,6(06):51-54.DOI:10.19757/j.cnki.issn1674-7763.2015.06.016.
2015-11-20
2015-11-20