| Objective：To explore the epidemiological situation, clinical features,treatment and outcome of183cases of congenital sysphilis（CS）, providetheoretical basis to prevent the CS and to increase the level of clinical diagnosisand treatment.Method：The clinical data of183subjects with CS that treated in ourhospital from January in2002to January in2011were retrospectively analyzed.The main content included the basic information of the children, the basicinformation of parents, clinical features, treatment and outcome. EXCELsoftware and SPSS16.0statistical software were used for statistical analysis.Results：1. From January in2002to January in2012, the number of cases whichwere admitted to our hospital each year accounting for the same period theproportion of children were0.16%(1case)、0.41%(4cases),0.34%(5cases),0.58%（10cases),0.62%(12cases),0.79%(19cases),0.53%(17cases),1.04%(37cases),0.76%(28cases),1.52%(50cases).2.183cases of congenital syphilis admitted in our hospital,7.7%(14cases)were latent syphilis,92.3%(169cases) were early congenital syphilis, no casesof late congenital syphilis. Which accounted for68.3%(125cases) ofnewborns,30.1%(55cases) of three months or less,1.6%(3cases) of threemonths later, and32.8%(60cases) of premature infants,30.6%(56cases) oflow birth weight babie,3.82%(7cases) of very Low birth weight infants.3. In all of these children’s mothers,36.1%(66cases) were syphilisdiagnosed before give birth, including41cases found in prenatal screening and25cases of previous history of syphilis, which3.3%(6cases) of the full courseof penicillin treatment.34cases of parental occupation recorded, in which 32.4%of farmers,29.4%of unemployed,17.6%of drivers,11.8%of individual,8.8%of technician.4. The first symptom as follows:30.2%(51cases) of skin lesions,18.9%(32cases) of yellowish discoloration of skin,14.2%(24cases) of difficulty inbreathing,11.1%(19cases) of abdominal distension,9.5%(16cases) of prtrem,6.5%(11cases) of fever,3.6%(6cases) of cough,1.2%(2cases) of poorresponse,1.2%(2cases) of poor feed,1.2%(2cases) of seizure,1.2%(2cases)of physical activity limited,0.6%(1cases) of edema.5. Organ involvement were as follows:60.7%(111cases) of liver injury,55.7%of the blood system (102cases),28.4%of respiratory system (52cases),27.9%(51cases) of skin lesions,27.6%(34cases) of urinary system,20.5%(16cases) of bone damage,14.9%(18cases) of nervous system.0.6%(1cases)of crying.71%(130cases) involving two or more than two organ systems.6. The penicillin group120cases, non-penicillin group63cases, The latterincludes cefuroxime32cases, sodium9cases, cefepime19cases,3casestreated with erythromycin. The two group was admitted with symptoms, signsand RPR titer by chi-square test showed no statistical significance.7. Short-term prognosis:27.9%(51cases) cured,55.7%(102cases)improved,11.5%(21cases) abandoned and4.9%(9cases) died. The incidenceof cured, improved, abandoned and died in group which treated by penicillinwere respectively38.3%,54.2%,7.5%,0and the incidence of group whichtreated by non-penicillin were respectively7.9%,58.7%,19%,14.3%. Twogroups of prognosis by chi-square test, P <0.05, there was statistical significantdifference.8. Long-term prognosis: on the discharge time of more than or equal6months of children by telephone follow-up, follow-up rate was44.4%(64cases), RPR negative rate was91.7%(55cases). The negatine rates of RPRwere respectively51.4%,81.1%,97.3%,100,100%in3months,6months,9 months,1years,2years of the penicillin group, and38.1%,57.1%,71.4%,76.2%,85.7%of non-penicillin group at the same time except for2death cases.Long term prognosis of two groups by chi-square test, P <0.05, there wasstatistical significant difference.Conclusion：1. Congenital syphilis incidence rate was rising year by year.2. Both rates of maternal prenatal detection and full treatment were low.3. Congenital syphilis for the early patients,3months or less, especiallynewbom babies.4. Variety of clinical manifestations, skin rashes were more common,which involves multiple systems, mainly with hepatosplenomegaly, rash, bloodsystem, urinary system, respiratory system and central nervous system.5. The short-term and long-term curative effect of penicillin group werebetter than non-penicillin group．... |
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