性传播疾病(八年制)概要.ppt

2、病理组织学检查 Koilocytosis (挖空细胞） Dyskeratosis（角化不良） Parakeratosis (角化不全） 3、Colposcopy 4、PCR（核酸检测--鉴定及分型） HC－II 1、妊娠期尖锐湿疣生长迅速 2、妊娠期疣体组织脆弱，阴道分娩时易导致大出血 3、 Infect delivery tract（通过软产道感染），幼儿期有发生喉乳头瘤的可能 妊娠合并尖锐湿疣 modality Efficacy(%) Recurrence risk Imiquimod 5% cream 咪喹莫特霜 33-72 13-19 Podophyllin 10-25%（鬼臼） 32-79 27-65 Podofilon 0.5% 足叶草毒素 45-88 33-60 Trichloroacetic acid80-90% 81 36 Cryotherapy 63-88 21-39 Electrodesiccation or cautery（电凝或电烧灼） 94 22 laser 43-93 29-95 interferon 44-61 0-67 Reactivation of subclinical infection (more often)  Reinfection by a sex partner 妊娠36周前孕妇患尖锐湿疣， Trichloroacetic acid and electrocoagulation may be used 物理及手术治疗。 分娩方式: 阴道分娩:妊娠近足月或足月孕妇患尖锐湿疣， 病灶局限于外阴者，物理或手术治疗后可阴道分娩 剖宫产:病灶广泛或病灶堵塞软产道者，应行剖宫产终止妊娠 Condyloma acuminata in pregnancy 第四节 生殖道衣原体感染 Genital chlamydial infection the columnar and transitional epithelium of genitourinary tract is principal site of invasion (without deep tissue invasion) cervix, and urethra may be inflamed Discharge: mucopurulent exudates Symptoms are not severe. Collect the sample from the endocervical canal with a small cotton swab No symptoms Cervicitis Endometritis Salpingitis: one of the etiology of infertility Clinical manifestation 因衣原体热休克蛋白与输卵管热休克蛋白有相似性，感染后引起的交叉免疫反应可损伤输卵管；若长期反复感染，其所致的迟发超敏反应可加重输卵管损伤；常导致严重输卵管黏膜结构破坏、功能丧失，并可引起盆腔广泛粘连 1. Giemsa stain of purulent discharge Diagnosis 2. Cell culture: is not yet widely available 3. Fluorescent antibody test: common used direct smear, 4. PCR 5. Serology tests， ELISA Diagnosis The antibiotic must have powerful penetrative ability and long half time Cervicitis: doxycycline: 100mg bid ×7-10 days azithromycin: 1g one dose Clarithromycin(克拉霉素）500mg bid ×10 d levofloxacin、erythromycin… PID: treat for 14 days Treatment abortion, chorioamnionitis, PROM, preterm birth, neonatal conjunctivitis and pneumonia Genital chlamydial infection in pregnancy 第五节 生殖器疱疹 Genital herpes Latent perio