先天性早发型骨梅毒X线表现

目的：探讨先天性骨梅毒X线表现及特点，评价X线照片检查在本病诊断中的价值。方法：回顾性分析最近5年25例早发型骨梅毒的临床资料和X线表现。结果：25例四肢长骨均有骨骼异常改变，按照病变累及的部位分为干骺端炎、骨膜炎、骨干(或骨髓炎)。全部病例均有干骺端炎，主要表现是先期钙化带增厚，部分呈锯齿状改变，钙化带下方出现横行透亮带。骨膜炎20例，表现单层或数层骨膜增生。骨干炎13例，部分骨干呈虫噬状骨质破坏，骨质内层增生，一般骨干不增粗，尺桡骨受累较多见。结论：本病四肢长骨具有病变多发、广泛、对称的特点，凡疑有先天性早发型骨梅毒病孩，应及早进行四肢长骨X线照片检查。     

早期先天性骨梅毒X线诊断（附16例报告）

目的：探讨早期先天性骨梅毒X线表现及特点。方法：对我院近年来经临床已证实，均有四肢长骨X线资料的16例早期先天性骨梅毒患进行分析。结果：其X线表现均有干骺端炎，其中13例表现为先期钙化带增厚及其下方宽带状低密度影；3例为干骺端不规则骨质破坏。骨膜炎5例，均伴有干骺端炎，显示葱皮状骨膜增厚。骨干炎2例，表现为斑点状骨质破坏及骨皮质增厚。16例患儿均有多骨受累、对称性分布、侵犯长骨为主、早期干骺端炎、骨骺不受侵犯等特点。结论：X线检查能确定病变范围及程度，给临床治疗和预后提供参考。     

早发型先天性骨梅毒的X线征象分析

目的探讨早发型先天性骨梅毒的X线征象,为临床及时诊断提供帮助.方法回顾15例经临床证实的15早发型先天性骨梅毒X线表现,结合文献进行分析.结果15例四肢长骨均见受累,多发性、对称性病变14例,局限性1例;干骺端炎13例,骨膜炎12例,伴骨髓炎2例.干骺端炎主要表现干骺端临时钙化带稍增厚、密度增高,其下方宽窄不一的透亮带,相邻骨干水平状致密白线,呈“夹心饼征;以及骨质破坏和尖角样突起.骨膜炎表现为两侧对称性沿骨干两侧呈层状、葱皮样骨膜增生.5例包括相邻手掌骨4例受累,其中多发对称性3例,病灶与长骨表现相似.髂骨沿骨皮质下透亮影6例.结论早发型先天性骨梅毒X线检查具有一定的特征性,结合临床,有助于及时诊断,并能提供病变累及的范围和程度.     

先天性早发型骨梅毒的X线表现

目的:探讨先天性早发型骨梅毒的X线表现及诊断.方法:对临床诊断的先天性梅毒患儿的四肢长骨X线平片进行分析.结果:21例患儿均有四肢长骨干骺端受累,7例患儿表现为骨干炎及骨髓炎,13例患儿具有骨膜炎表现.结论:X线检查对新生儿早发型骨梅毒的诊断有重要作用,并可以明确病变范围.     

先天性早发型骨梅毒X线诊断分析

目的 探讨先天性早发型骨梅毒X线表现及其特点,提高对本病的认识,减少误诊,评价X线检查对本病的诊断价值.材料和方法:结合文献,回顾性分析我院2002-2009年间诊治的21例先天性早发型骨梅毒的病例,全部病例经血清学证实并均摄取四肢长骨X线片.结果 21例四肢长骨均有不同程度的骨异常改变,X线表现为:干骺端炎21例,主要表现为先期钙化带致密增厚,其下方可见横行透亮带;2例双胫骨近端内侧对称性骨破坏,称Wimberger征,相对应股骨远端内侧骨质可见骨稀疏或破坏改变;骨干炎4例,主要累及尺桡骨,显示轻度的斑片状和虫蚀状破坏,骨皮质增厚;骨膜炎9例,表现为层状骨膜增厚,其中2例伴有骨干炎,9例伴有干骺端炎.结论 先天性早发型骨梅毒的病变具有多发、广泛,几乎累及所有四肢长骨,且呈对称分布的干骺端炎、骨干炎、骨膜炎,骨骺几乎不受侵犯的特点.X线检查在先天性早发型骨梅毒诊断中具有重要的价值,其不仅有助于诊断,还能发现病变的部位、范围和程度,并为临床治疗和预后提供参考.     

早发型先天性骨梅毒的X线诊断42例分析

４２例早发型先天性骨梅毒患儿的Ｘ线发迹累及四肢长骨的多发对称性及广泛性软组织肿胀、骨膜炎、干骺端炎及骨髓炎。临时外化带增宽及其下方出现透亮带与干骺端骨质破坏，碎裂、局灶性骨质缺损为本病特征性的Ｘ线表现。     

早发型先天性骨梅毒的X线诊断42例分析

４２例早发型先天性骨梅毒患儿的ｘ线改变为累及四肢长骨的多发对称性及广泛性软组织肿胀、骨膜炎、干骺端炎及骨髓炎。临时钙化带增宽及其下方出现透亮带与干骺端骨质破坏、碎裂、局灶性骨质缺损为本病特征性的Ｘ线表现。     

新生儿先天性骨梅毒X线诊断价值(附8例病例报道)

目的：探讨X线对新生儿骨梅毒的诊断价值,旨在提高对本病的认识。方法：分析8例新生儿先天性骨梅毒患儿的病理基础、骨骼X线征象和实验室检查。8例新生儿骨梅毒的病例均摄四肢长骨、胸、腹部正位片,5例摄头颅正侧位片。结果：8例病例四肢长骨均有不同程度的骨质改变,其特点为多发、广泛、对称性改变。按病变累及的部位分为干骺端炎7例,骨髓炎3例,骨膜炎6例。结论：X线及实验室检查是目前诊断新生儿先天性骨梅毒的丛要方法。可及时、准确地为临床提供诊断。     

14例后天性原发型骨关节梅毒的X线诊断

目的：探讨后天性原发型骨关节梅毒的X线特点,方法：W一部病例的分析 基本常规正侧位X线平片,结果：骨关节梅毒的共同特点是病骨的膨胀、畸形。长骨以胫骨为主要受累部位,病变基本特点是,对称性、多骨、多关节受累,不同程度的骨硬化及骨炎,骨膜炎,结论：X线改变具有一定特征性,据此典型X线表现即可做正确诊断,并可确定病变部位、范围及程度。     

先天性梅毒患儿肺部、四肢骨骼的X线及颅脑超声征象的特点分析

目的通过分析先天性梅毒患儿肺部、四肢骨骼X线征象的改变及颅脑超声的表现,总结出早期诊断的方法。方法对84例确诊的先天性梅毒患儿进行胸部和四肢骨骼的X线检查及颅脑超声检查,并进行分析、总结。结果84例患儿中胸片异常的有54例,占64.2%,以肺炎表现为主;四肢骨骼改变的有30例,占35.7%,病变以长骨干骺端为主;颅脑超声异常27例,占32.1%,以室管膜下出血及囊性改变为主。结论简便的胸及骨骼X线摄片与颅脑超声检查有助于先天性梅毒的早期诊断,可为治疗和预后提供重要参考。     

先天性梅毒的早期临床及骨骼X线特征

目的探讨先天性梅毒的早期临床及骨骼X线特征。方法回顾性分析75例确诊为先天性梅毒的临床及X线特征,所有患儿均有骨骼系统X线检查,其中男性43例,女性32例,年龄4h～6个月,平均年龄21天。结果 75例患儿中,13例无明显临床症状;62例有不同临床症状,其中43例累及皮肤、黏膜,25例累及肺及肝脏等内脏器官,7例有肢体活动障碍或肿胀。15例骨骼系统有异常改变,主要包括干骺端软骨炎12例,骨膜炎6例,骨干炎5例。结论先天性梅毒临床表现多样,及时的实验室检查和骨骼系统X检查有助于早期诊断。     

107例先天梅毒临床流行病学研究

目的先天梅毒(congenital syphilis,CS)近年在中国呈快速上升趋势,本文通过研究先天梅毒临床流行病学,旨在分析当前先天梅毒诊疗中存在的问题。方法对1999年2月至2003年2月间复旦大学附属儿科医院收治的107例先天梅毒患儿围产期、临床诊疗资料进行分析。结果在先天梅毒患儿母亲中,89.7%为流动人口,30.8%未进行妊娠期梅毒血清学筛查,94.4%未予正规青霉素治疗。先天梅毒新生儿期表现多变,以皮肤黏膜、骨骼损害较为特异,其比例分别为72%、40%。结论先天梅毒的发生多见于流动人口,孕妇缺乏梅毒血清学筛查和正规青霉素治疗是导致先天梅毒发生的最主要因素,政府应该加强对流动人口先天梅毒防治的管理。     

Congenital syphilis in Nebraska: a case report.

In the United States, the incidence of acquired syphilis has increased thirty four percent in the last decade with young, black, urban dwelling, drug dependent females representing the highest risk group. Concomitantly, congenital syphilis has increased causing spontaneous abortions, stillbirths, and neonatal morbidity and longterm neurologic sequela. Because physicians are no longer familiar with the disease, it is estimated that only twenty-five percent of neonatal syphilis is diagnosed during the first year of life. This report describes the first reported case of congenital syphilis in Nebraska. Our patient demonstrates the typical clinical findings of lethargy, extremity swelling and the pseudoparalysis of Parot, while laboratory evaluation showed anemia, abnormal hepatic enzymes, hypoproteinemia, and confirmatory positive neonatal VDRL and FTA-ABS. The plain film radiographic survey illustrated the characteristic findings of periostitis, metaphyseal banding and cortical erosion. By relying upon the relatively inexpensive and easy to obtain radiographic long bone survey a prompt diagnosis can be made and immediate treatment instituted while awaiting confirmatory serology. We must reacquaint ourselves with the increasing incidence of acquired and congenital syphilis. This will enable us to make a timely and cost-effective diagnosis of cogenital syphilis and prevent its devastating complications.     

258例早期梅毒临床分析

[背景]了解梅毒患者的临床特点.[病例报告]对1998年—2004年间延边大学医院性病诊察室诊断并治疗的258例早期梅毒患者进行回顾性分析,见一期梅毒占25.58%,二期梅毒占51.94%,潜伏期梅毒占21.32%,早期先天性梅毒占1.16%;梅毒高发年龄段为20~39岁;职业以个体从业者为居多;学历以中学及中学以下者为居多;临床表现:一期梅毒患者以硬下疳为主,二期梅毒患者以斑疹型皮肤损伤为主.[讨论]先天性梅毒及潜伏期梅毒患病率呈逐年上升趋势,而梅毒血清检测应作为梅毒高发人群的常规检查项目.     

Value of routine long bone radiographs in management of babies with a positive VDRL at the Mount Hope Women's Hospital

This retrospective study examined the records of 44 mothers and 44 babies with a positive blood VDRL test and/or who showed symptoms of congenital syphilis at the Mount Hope Women's Hospital (MHWH), Trinidad, between June 1, 1996 and September 30, 1998. Long bone radiographs of 40/44 (91%) babies were assessed independently by two radiologists for signs of congenital syphilis and the data were analysed using frequency tables. Of the 44 mothers in the study, 34 (77%) were VDRL positive and the rest were either negative or unknown. Maternal age ranged from 14 to 39 years and most (92%) had antenatal care. Fourteen of the 34 (41%) VDRL positive mothers received treatment antenatally. All mothers were asymptomatic and none had any clinical features of syphilis. In 35/44 babies, the VDRL test was positive and in nine, the test was either negative or unknown. Twenty-six of the babies had signs suggestive of congenital syphilis and in 12, (46%) long bone radiographs revealed changes compatible with the diagnosis of congenital syphilis. Radiographic abnormalities were present only in infants with VDRL titres > 1:8.     

梅毒孕妇及其患儿的临床表现与梅毒抗体的分析研究

目的 了解梅毒孕妇及其先天梅毒患儿的临床特点及血清、脑脊液梅毒抗体的检测情况。方法 对40例梅毒孕妇及其所产婴儿进行了临床特点和血清、脑脊液梅毒抗体的分析。结果 40例梅毒孕妇中，潜伏梅毒占87．5％，TPPA检测均阳性，RPR阳性的有35例，滴度介于1：1—1：128之间；40例先天梅毒患儿中出现皮疹的有14例（35％），有骨损害表现的6例（15％），由于母亲忘梅毒而就诊的16例（40％），RPR检测阳性33例（82，5％），滴度介于1：1～1：64之间，2例RPR异常增高，滴度为1：128。脑脊液常规检查显示，45％患儿淋巴细胞增高，50％蛋白增多，22．5％梅毒抗体检测阳性。结论应重视妊娠期梅毒筛查，对于确诊的先天梅毒患儿，注意无症状神经梅毒的发生，为正确评价病情和治疗有重大意义。     

新生儿先天性梅毒的早期诊断和治疗

目的分析新生儿先天性梅毒进行早干预、早诊断、早治疗和减少新生儿病残率和死亡率的效果。方法对28例确诊先天性梅毒的新生儿进行临床资料和治疗转归分析。结果本组25例经治疗后,临床症状基本消失,出院后3个月复查TPHA试验均阴性。结论对高危孕妇、高危儿常规进行筛查及随访,做到早期干预确诊、早期诊治、早期治疗。     

Congenital syphilis has not disappeared

Thirty-three cases of congenital syphilis that were seen at The Children's Hospital, Camperdown, over a 34-year period were reviewed. Twenty-nine cases were examples of early congenital syphilis, as the patients developed clinical features in the first two years of life, and the other four cases were examples of late congenital syphilis, with the clinical features developing between two years and nine months of age and 10 years of age. Twenty-five patients were symptomatic at the time of admission to hospital. The most common clinical feature on the patient's presentation to hospital was a maculopapular or vesiculobullous skin eruption which occurred in 13 of the infants. Hepatic and splenic enlargement were present in 12 cases, and nine children had the "snuffles". Five of the children died. Patient follow-up occurred in fewer than 40% of cases and three of the children who were followed-up suffer from developmental delay. Congenital syphilis can occur in all social groups but is most common in infants who are premature or are small for gestational age and are born to young, unmarried mothers of low socioeconomic status. The treatment of congenital syphilis is simple and effective although the patients may need to be linked with community-health facilities to assist in their compliance with follow-up appointments.     

早期先天性梅毒脏器损害的临床分析简

目的 探讨早期先天性梅毒脏器损害的临床特点,提高早期诊疗水平.方法 对2011年1月-2013年7月收治的24例早期先天性梅毒患儿的临床资料进行回顾性分析,总结其临床特征.结果 24例患儿中,皮肤损害者15例（63％）,肝脏损害者14例（58％）,血液系统损害者11例（46％）,肺脏损害者7例（29％）,消化系统损害者6例（25％）,心脏损害者3例（12％）,肌肉骨骼损害者2例（8％）,神经系统损害者2例（8％）,多脏器损害者19例（79％）.结论 早期先天性梅毒临床表现多样,可引起多个脏器损害,对不明原因的皮疹、肝功损害、贫血、发热、腹胀等临床表现的小儿应引起重视,及时进行筛查先天性梅毒,以利于该病早期诊断和治疗.