不同治疗时机对妊娠梅毒的预后影响研究

不同治疗时机对妊娠梅毒的预后影响研究 　　【摘要】目的　探讨不同时机妊娠梅毒治疗对患儿预后的影响。方法选取2008年1月～2010年4月于我院进行生产治疗的妊娠梅毒患者80例为研究对象，将其随机分为A组（≤12周治疗组）20例、B组（13～28周治疗组）20例、C组（≥29周治疗组）20例和D组（未治疗组）20例，将四组患者的足月分娩率、早产率、死胎率及低体重儿发生率、畸形率、Apgar评分及母婴RPR滴度进行检测及比较。结果经研究比较发现，A组的足月分娩率高于B、C及D组，以D组最低，A组的早产率、死胎率及低体重儿发生率、畸形率均低于B、C及D组，以D组最高，A组1min及5minApgar评分均优于B、C及D组，母婴RPR滴度A组也最佳，其中A组中治疗2个疗程者母婴RPR滴度优于1个疗程者，P均＜0.05，均有显著性差异。结论早期的治疗对改善妊娠梅毒的预后有着积极的意义，因此主张早期的治疗。 　　【关键词】  治疗时机；妊娠梅毒；预后；影响 　　AbstractObjectiveTo discuss the effect of different curative opportunities on the prognosis of pregnant syphilis. Methods80 cases with pregnant syphilis were randomly divided into 4 groups: group A (≤12 gestational weeks), group B (from 13 to 28 gestational weeks), group C (≥29 gestational weeks) and group D, 20 cases in each group; patients in group A, B and C received certain treatment but those in group D received no; the tem delivery rates, premature delivery rates, fetal death rat, occurrences of low weight infants, deformity rates, Apgar scores and titers of RPR of mothers and infants were detected and a comparison was made among the 4 groups. ResultsThe term delivery rate of group A was higher than those in group B, group C and group D, that of group D was the lowest; the premature delivery rate, fetal death rate, occurrence of low weight infants and deformity rate in group A were all lower than those in group B, group C and group D, those rates in group D were the highest; group A was superior in the 1st min and 5th min Apgar scores to those in group B, group C and group D; the detection results of the titers of RPR of mothers and infants in group A were good, especially those of mothers and infants having 2 courses of treatment, even better than those of mothers and infants having 1 course of treatment (P＜0.05);the differences among the 4 groups were significant. ConclusionsEarly treatment has a positive effect on the prognosis of the patients with pregnant syphilis. 　　KEYWORDScurative opportunitypregnant syphilis prognosiseffect 　　如何治疗以改善妊娠梅毒的预后非常重要，以往的报道也较多，但对于治疗时机的选择的报道较少［1-2］。本文中就不同治疗时机对妊娠梅毒的预后的影响进行研究，现将结果报道如下。 　　1资料与方法 　　1.1临床资料 　　选取2008年1月～2010年4月于我院进行生产治疗的妊娠梅毒患者80例为研究对象，将其随机分为A组（≤12周治疗组）20例、B组（13～28周治疗组）20例、C组（≥29周治疗组）20例和D组（未治疗组）20例。A组的20例中，年龄22～36岁，平均（26.8±3.2）岁，其中初产妇13例，经产妇7例，均于妊娠12周内进行治疗；B组的20例中，年龄21～35岁，平均（26.2±3.7）岁，其中初产妇14例，经产妇6例，均于妊娠13～28周内进行治疗；C组的20例中，年龄20～34岁，平均（25.9±4.1）岁，其中初产妇12例，经产妇8例，均于妊娠29周及以后进行治疗；D组的20例中，年龄23～37岁，平均（26.1±3.8）岁，其中初产妇13例，经产妇7例，均未进行治疗。四组患者在年龄及经、初产构成比方面比较，P均＞0.05，具有可比性。所有产妇均为单胎。 　　1.2方法 　　A组、B组及C组均采用苄星青霉素常规治疗进行治疗，给予患者苄星青霉素240万单位，肌内注射，1次/周，3次为1个疗程，其中部分患者进行第二疗程的治疗，第一与第二疗程间间隔2周［3］，过敏者采用盐酸四环素、红霉素等进行治疗［4］。后将四组患者的足月分娩率、早产率、死胎率及低体重儿发生率、畸形率、Apgar评分及母婴RPR滴度进行检测及比较。 　　.3统计学方法 　　将文中检测所得的数据采用统计学软件进行相关处理，统计学软件选用SPSS12.0，计量资料采用t检验，计数资料采用χ2检验，采用P＜0.05为有显著性差异。 　　2结果