梅毒检验培训课件.pptVIP

孕产妇梅毒检测 首都医科大学附属北京佑安医院 赵秀英 主要内容 梅毒与先天梅毒 梅毒的检测方法 孕产妇梅毒检测及服务流程 梅毒与先天梅毒 梅 毒 梅毒是苍白螺旋体（又名梅毒螺旋体）感染人体所引起的一种系统性、慢性性传播疾病 多系统多脏器的损害，多种多样的临床表现，导致组织破坏、功能失常，甚至危及生命 感染后至发病平均为3周,潜伏期一般为2～3周 人体对梅毒体无天然免疫力，感染后可建立短暂免疫力，治愈后可再感染 历史回顾 记录显示梅毒起源于美洲 1492年,哥伦布踏上美洲，把这种瘟疫带回了欧洲 之后数十年，梅毒在西班牙、葡萄牙、法国、意大利、荷兰传播。法国军队在拿破仑的带领下，把梅毒带到欧洲的每一个角落，包括莫斯科 16世纪上半叶，梅毒沿着的海上丝绸之路，自西向东传播，印度、南洋、中国的东南沿海……古代中国曾称其为“花柳病” China has seen a dramatic rise in cases of syphilis, as a result of rapid social change, US researchers say. A report in the New England Journal of Medicine says syphilis is now the most commonly reported communicable disease in Shanghai, the second-largest city. Pregnant women are also increasingly passing the disease to their children, with more than one baby with congenital syphilis born every hour in 2008. No other country has seen such a rise since the discovery of penicillin. Syphilis was almost eradicated from China in the 1950s with a sweeping programme of antibiotics and brothel shutdowns. The researchers say the disease is now a major scourge lurking in the shadows, with around 20 people in every 100,000 in China carrying the infection. China’s economic reforms and the growing number of migrant workers and men with expendable income, which has led to a growth in the commercial sex industry. Female sex workers and gay or bisexual men – a third of whom are married – disproportionately bear the burden of the epidemic, they say. Syphilis…….. but can cause paralysis, blindness and death if left untreated. Mothers can pass syphilis to unborn babies, which can lead to deformities, neurological problems, stillbirths or death in early infancy. 传播方式 性接触 母婴传播 经由胎盘传染 分娩时与伤口接触 输血或血制品 接触后患梅毒的概率为40% 临床表现 一期梅毒　　1 病史：有感染史，潜伏期一般为2～3周　　2 临床表现：　　a. 典型硬下疳：一般单发，1～2cm大小，圆形或椭圆形，稍高出皮面，呈肉红色的糜烂面或浅在性溃疡。疮面清洁，分泌物量少，周边及基底浸润明显具软骨样硬度，无痛。多发于外生殖器，也可见于肛门、宫颈、口唇、乳房等部位　　b. 腹股沟或患部近卫淋巴结可肿大，常为数个，大小不等，质硬，不粘连，不破溃，无痛。 临床表现 二期梅毒　　1 病史：有感染史，可有一期梅毒史，病期2年以内　　2 临床表现：　　a. 皮疹为多形态，包括斑疹、斑丘疹、丘疹、鳞屑性皮疹及脓疱疹等，常泛发对称；掌、跖易见暗红斑及脱屑