- 期刊
嬰兒先天性梅毒之臨床分析
Clinical Analysis of Congenital Syphilis in Infancy
摘要
我們收集馬偕紀念醫院小兒科近15年來，符合先天性梅毒診斷之31例住院患者，就其性別、年齡、家族歴、臨床症狀、預後追蹤，作一分析。其結果是男女比爲1.2:1，早産兒佔51.6%，低體重兒亦佔51.6%。就醫年齡87.1%在出生2個月內。入院主訴以腹脹、延長性黃疸、發燒、呼吸困難爲最多。臨床症狀以肝脾腫大(73.6%)、黃疸(57.6%)、腹脹(48%)、呼吸困難(48%)爲主。血液檢查：1/2有貧血現象、2/3有肝炎。血清梅毒反應(STS)以VDRL或RPR爲依據，其效價大多介於1:8現1:64間。長骨X光攝影：以兩側股骨(66.6%)、肱骨(42.8%)、脛骨(33.3%)之病變爲最多。大多數患兒在接受盤尼西林治療後，3至7天病情改善，平均治療10至14天。病情追蹤結果：痊癒者7例，症狀改善者12例，死於呼吸衰竭者4例，狀況不明者8例。
關鍵字
無資料並列摘要
Thirty-one case of early congenital syphilis admitted to the Department of Pediatrics of Mackay Memorial Hospital from January 1971 to December 1985 Were analyzed. The ratio of male to female was 1.2 to 1. About 90% of the cases were below 2-month-old. Most of them were from the lower socioeconomic family. Abdominal distension, prolonged jaundice, fever and dyspnea were the most common symptoms on their first visit. The most common clinical manifestations were hepatosplenomegaly, jaundice, abdominal distension and dyspnea, The increase of atypical symptoms and signs is also noteable as compared with the previous reports from other series. Most cases showed leukocytosis and about a halt of the cases disclosed anemia on the blood picture. Mild hepatic impairment was noted in two-third of the examined cases. Two cases showed positive VDRL reaction on CSF. One of the most characteristic findings of early congenital syphilis was the roentgenologic pictures of the skeletal system. The most commonly invaded bones femur, humerus and tibia on both sides. The drug of choice was penicillin. The clinical manifestations improved after 3 to 7 days of the therapy and disappeared by the end of the second week of the therapy in most cases. Twenty-three cases had complications and four of them died of respiratory failure. After treatment, the serological change and X-ray follow up on the long bone series are also presented. The importance of prenatal care. Early diagnosis and treatment is emphasized.