妊娠期梅毒临床干预对妊娠结局的影响分析

Analysis of the effect of clinical intervention of syphilis during pregnancy on pregnancy outcome

目的研究妊娠期梅毒治疗对妊娠结局的影响。方法选择经过血清学检查确诊的55例妊娠期梅毒孕妇的临床资料进行分析研究。55例梅毒感染孕产妇中,除3例早期发现感染梅毒终止妊娠外,其余患者均按不同程度的临床治疗干预,随机分为规范治疗组(G组,36例)和非规范治疗组(N组,16例)。观察妊娠期梅毒的临床治疗干预对妊娠结局的影响。结果 N组(2例死胎及其产妇未检测TRUST)与G组产妇TRUST滴度相比,差异有统计学意义(P<0.05);两组新生儿TRUST滴度相比,差异有统计学意义(P<0.05)。G组早产、死胎、死产发生率明显低于N组,差异有统计学意义(P<0.05)。随访发现,产时母亲TRUST阴性所生新生儿皆为阴性,G组新生儿滴度较低者随访3个月-6个月很快转阴,N组滴度较高者转阴较慢。49例活产儿,除4例仍在随访,目前未发现先天梅毒患儿。结论开展婚前、孕前、孕早期梅毒血清学筛查,及时规范治疗,是改善妊娠期梅毒妊娠结局,降低先天梅毒发生的关键。

Objective To study the effect of syphilis treatment on pregnancy outcome during pregnancy.Methods The clinical data of55pregnant women with syphilis confirmed by serological examination were analyzed.Among55pregnant and lying-in women with syphilis infection,except for3cases of early detection of syphilis infection and termination of pregnancy,the other patients were randomly divided into standard treatment group(group G,36cases)and non-standard treatment group(group N,16cases).To observe the effect of clinical intervention on pregnancy outcome during pregnancy.Results There was significant difference in TRUST titer between group N(2stillbirths and their mothers without TRUST detection)and group G(P<0.05);there was significant difference in TRUST titer between the two groups(P<0.05).The incidence of premature delivery,stillbirth and stillbirth in group G was significantly lower than that in group N(P<0.05).Follow-up showed that all neonates born to mothers with TRUST negative were negative.Neonates with lower titers in group G quickly turned negative after3to6months of follow-up,while those with higher titers in group N slowly turned negative.In49cases of live births,4cases were still being followed up,and no congenital syphilis was found.Conclusion Serological screening of syphilis before marriage,before pregnancy and early pregnancy and timely standardized treatment are the key to improve the pregnancy outcome of syphilis during pregnancy and reduce the occurrence of congenital syphilis.