不同青霉素治疗妊娠梅毒患者的妊娠不良结局及随诊情况

目的探讨普鲁卡因青霉素与苄星青霉素治疗妊娠梅毒患者的妊娠结局不良率及随诊率有无差异。方法收集2009年3月至2011年3月门诊159例妊娠梅毒患者,根据患者处理方式的不同,分组进行比较。结果 A组为普鲁卡因青霉素治疗组,有效病例53例,普鲁卡因青霉素80万单位肌肉注射,每日1次,连续15日;B组为苄星青霉素治疗组,有效病例75例,苄星青霉素240万单位肌肉注射,每周1次,连续3周;C组为未治疗组,有效病例9例,D组为快速血浆反应素环状卡片试验（RPR）及梅毒螺旋体血球凝集试验（TPHA）均阴性的正常孕妇159例。A、B、C、D组妊娠结局异常率分别为18.87%（10/53）、17.33%（13/75）、66.67%（6/9）、15.72%（25/159）,C、D组间,A、C组间,B、C组间差异均有统计学意义;A、D组间,B、D组间,A、B组间,差异均无统计学意义。A、B组随诊率分别为76.81%、92.59%,两组间随诊率差异有统计学意义。结论未治疗组妊娠梅毒的妊娠结局不良率远高于治疗组及正常孕妇组,治疗组的妊娠结局不良率与正常孕妇组无明显差异,且2种青霉素治疗组间无明显差异,但2治疗组间随诊率有差异。

An analysis of adverse pregnancy outcome and follow-up among pregnant women with syphilis treated with penicillin

Objective To investigate the adverse pregnancy outcome and follow-up rate among pregnant women with syphilis treated with procaine penicillin and benzathine penicillin.Methods One hundred and fifty nine pregnant women with syphilis visiting outpatient departments from March 2009 to March 2011 were surveyed and were divided into different groups according to different methods of handling.Results Group A included 53 significant cases treated with procaine penicillin,80 thousand units,intramuscular injection,once daily,for 15 days;Group B included 75 significant cases treated with benzathine penicillin,240 thousand units,two sides of gluteal muscle injection,once a week,for three weeks;Group C included nine cases who had not received any treatment;Group D included 159 normal pregnant women,whose rapid plasma reagin（RPR） and treponema pallidum hemagglutination assay（TPHA） were negative.The rates of abnormal pregnancy outcomes of A,B,C,D groups were 18.87%,17.33%,66.67%,15.72%,respectively.The differences between groups C and D,groups A and C,groups B and C had statistical significance.The differences between groups A and D,groups B and D,groups A and B had no statistical significance.Follow-up rates in groups A and B were 76.81% and 92.59%,respectively;the difference between the two groups had statistical significance.Conclusion The adverse pregnancy outcome in the non-treatment group is far higher than in the treatment group and the group of normal pregnant women.The adverse pregnancy outcomes in the treatment group and the group of normal pregnant women have no significant difference,and two kinds of penicillin in the treatment group show no significant differences between the two treatment groups,but the follow-up rate has difference.