梅毒检验培训课件教材课程.ppt

孕产妇梅毒检测;主要内容;梅毒与先天梅毒 ;梅 毒;历史回顾;;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. ;临床表现;临床表现;临床表现;梅 毒;梅 毒;梅 毒;临床表现;妊娠梅毒;胎传梅毒（先天梅毒）; 先天性梅毒的危险因素;早期先天性梅毒的临床表现;先天性梅毒;;;先天性梅毒;先天性梅毒;晚期先天性梅毒的临床表现;Hutchinson’s 三症（先天性梅毒晚期）： 间质性角膜炎 牙齿畸形 耳聋;先天性梅毒;梅毒性关节炎;马鞍鼻;军刀状胫（胫骨前凸）;治疗原则;梅毒感染孕产妇及所生儿童治疗方案;二、梅毒感染孕产妇所生新生儿的预防性治疗方案 出生后应用苄星青霉素G，5万单位/公斤体重，肌注 三、先天梅毒患儿的治疗方案 （一）脑脊液正常者：苄星青霉素G，5万单位/公斤，1次注射 （二）脑脊液异常者：水剂青霉素G，每日5万单位/公斤，分2次静脉滴注，连续10～14天；或普鲁卡因青霉素G，每日5万单位/公斤，肌注，连续10～14天 无条件检查脑脊液者，可按脑脊液异常者治疗 ; 梅毒治愈标准;治疗后观察; 晚期??毒疗后复查同早期梅毒，但应连续观察3年，血清反应固定阳性者，应作神经系统检查及脑脊液检查 妊娠梅毒治疗后，分娩前每月复查梅毒血清反应，分娩后观察同其他梅毒，但所生婴儿要观察到血清阴性为止，如发现滴度升高或有症状发生，应立即进行治疗 ;梅毒的检测方法 ;梅毒检测方法;暗视野显微镜;未检出螺旋体不能排除梅毒的诊断 ①螺旋体数量不足(单次显微镜检查阳性率小于50%) ②患者已接受抗生素或杀灭梅毒螺旋体的药物治疗 ③损害接近自然消退 ④损害不是梅毒;梅毒血清学检测;螺旋体体内的心磷脂、