先天梅毒28例临床分析及治疗探讨

Investigation of Clinical Manifestation and Treatment of 28 Cases with Early Congenital Syphilis

目的总结先天梅毒的临床表现及治疗方法。方法对28例先天梅毒的临床资料进行回顾性分析。结果所有患儿母亲孕期均未做梅毒筛查及母婴阻断治疗。患儿临床表现以皮疹(20例)、贫血(16例)、脏器受累(14例)、低体重(8例)、早产(4例)、神经系统损害(4例)、骨骼受累(2例)多见。5例予以水剂青霉素、17例予以头孢曲松加苄星青霉素治疗,4例单用头孢曲松治疗。治愈25例,复发1例,死亡1例,放弃治疗1例。结论先天梅毒临床表现多样,以皮肤损害、营养发育障碍为主,可伴有神经系统及内脏、骨骼受累。青霉素疗效满意。应加强孕早期梅毒筛查工作以预防先天梅毒的发生。

Objective To investigate the clinical manifestation and treatment of early congenital syphilis. Methods 28 cases of early congenital syphilis were retrospectively studied between 2006 and 2007. Results 28 mothers had not received screening test for syphilis during pregnancy. Rash over the buttocks and extremities （20/28） ,anemia （16/28） ,low birth weight （8/28） , preterm deliveries （4/28）, viscera （ 14/28 ） and nerve system （4/28） and skeletal （2/28） involvement was common. 5 cases were treated with penicillin G, 17 cases were treated with Ceftriaxone ＋ benzathine penicillin,4 cases were treated with Ceftriaxone. 25 cases achieved clinical and serum cure , 1 case relapsed, 1 case died, and 1 case gave up treatment. Conclusion skin manifestation,malnutrition and physical hypoplasia is the most common in early congenital syphilis, maybe accompanied with internal or- gans,nerve system and skeleton involvement. Cases with early congenital syphilis should be treated with a penicillin-based regimen. All pregnant women should receive an adequate prenatal care including obligatory screening test for syphilis in order to prevent congenital syphilis.