妊娠期梅毒临床结局的相关因素分析及临床诊治

目的：分析影响梅毒患者妊娠结局的相关因素，探讨妊娠期梅毒的诊断与治疗方法，最大限度地提高新生儿结局。方法：选择我院2010年1月至2013年3月131例妊娠合并梅毒患者资料进行分析，其中82例孕产妇在产前经血清学筛查确诊后给予驱梅治疗，49例孕产妇于临产经输血前四项指标筛查确诊，未进行驱梅治疗，对两组产妇与新生儿结局进行分析，同时探讨妊娠期梅毒患者的诊治方法。结果：治疗组共发生新生儿先天性梅毒17例，发生率为20．73％；未治疗组共发生先天性梅毒29例，发生率为59．18％。治疗组死胎、早产发生率均低于未治疗组，流产发生率高于未治疗组，早孕组新生儿先天性梅毒发生率、死胎率、不良妊娠发生率明显低于晚孕组，流产、早产发生率高于晚孕组与中孕组，两组比较差异具有显著性（P〈0．05）。剖宫产组新生儿先天性梅毒感染40例，感染率为33．33％；阴道分娩组感染6例，感染率为54．55％，阴道分娩感染率明显高于剖宫产，两种分娩方式感染率比较差异具有显著性（P〈0．05）。结论：妊娠期梅毒是导致新生儿结局不良的危险因素，分娩方式、治疗时间及科学规范的驱梅治疗可提高新生儿结局。

Clinical outcomes of syphilis during pregnancy

Objectives： To analyze the factors that affect the pregnancy outcome in patients with syphilis in order to explore the diagnosis and treatment of syphilis during pregnancy, and to maximize neonatal outcomes. Methods： the data of 131 pregnant women with syphilis presenting in our hospital from January 2010 to March 2013 were analyzed, of which 82 eases of maternal prenatal were given treatment after serological screening, and 49 cases were not treated after diagnosing four indicators in the pre - transfusion screening diagnosis. The outcomes of the two groups pf maternal and neonatal women were analyzed to explore the diagnosis and treatment of patients with syphilis during pregnancy. Results： In the treatment group, there were 17 eases of con- genital syphilis, at the rate of 20.73%. In the untreated group there were 29 cases of congenital syphilis, with the incidence rate 59.18%. The stillbirth, premature delivery rates in the treatment were lower than those in the untreated group , while the inci- dence of abortion was higher in the untreated group, as well as the miscarriage, premature delivery, and the incidence of adverse pregnancy of congenital syphilis incidence. While the stillbirth rate was significantly lower than that in the pregnant group. The difference is significant （ P 〈 0.05 ）. There were 40 cases of cesarean section in the group of congenital syphilis infection, with the infection rate 33.33% ; while in the vaginal delivery group 6 cases were infected, with the infection rate 54.55%. The vagi- nal delivery infection was significantly higher than the cesarean section, and the difference was significant （ P 〈 0.05 ）. Conclu- sions： syphilis during pregnancy is a risk factor for adverse neonatal outcomes. The mode of delivery, duration of treatment and scientific and standardized treatment of syphilis can improve neonatal outcomes.