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2016TORCH感染筛查、诊断与干预原则和工作流程专家共识发布

2016-07-15 MedSci MedSci原创

TORCH感染
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在围产学界通常将弓形虫（TOX）、风疹病毒（RV）、巨细胞病毒（CMV）、单纯疱疹病毒（HSV）以及其他病原体（如微小病毒 B19）合并简称为TORCH。其宫内感染与不良妊娠结局和出生缺陷的相关性早有报道。最近巴西爆发的寨卡病毒（Zika virus）宫内感染导致新生儿小头畸形再次引起了全球对宫内感染问题的关注。 对TORCH感染的诊断需要明确孕妇是否感染、何时感染、胎儿是否感染、胎儿是

在围产学界通常将弓形虫（TOX）、风疹病毒（RV）、巨细胞病毒（CMV）、单纯疱疹病毒（HSV）以及其他病原体（如微小病毒 B19）合并简称为TORCH。其宫内感染与不良妊娠结局和出生缺陷的相关性早有报道。最近巴西爆发的寨卡病毒（Zika virus）宫内感染导致新生儿小头畸形再次引起了全球对宫内感染问题的关注。
 
对TORCH感染的诊断需要明确孕妇是否感染、何时感染、胎儿是否感染、胎儿是否受到损害、是否能继续妊娠等问题。
 
近几年，国内外相继更新了TORCH感染筛查与诊断相关的临床指南，但在检测、诊断和干预等问题上尚有内容需要补充，需要确定较规范的工作原则和流程。
 
2016年国内相关学科临床专家对TORCH感染筛查、诊断与干预中存在的普遍性问题进行专题研讨，达成专家共识如下。
 
1 TORCH感染的筛查原则
2 TORCH感染的临床常见征象
3 孕妇TORCH感染与胎儿宫内感染
4 TORCH感染的筛查与诊断方法
5 TORCH宫内感染的影像学表现
6 TORCH宫内感染的门诊咨询要点
7 TORCH感染和宫内感染的临床干预


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  1. [GetPortalCommentsPageByObjectIdResponse(id=1968546, encodeId=e8481968546a8, content=<a href='/topic/show?id=a6541e664ae' target=_blank style='color:#2F92EE;'>#TORCH#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17664, encryptionId=a6541e664ae, topicName=TORCH)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=325a197, createdName=amyloid, createdTime=Sat Sep 10 02:07:00 CST 2016, time=2016-09-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2041934, encodeId=00a5204193492, content=<a href='/topic/show?id=d8684e896de' target=_blank style='color:#2F92EE;'>#工作流程#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47896, encryptionId=d8684e896de, topicName=工作流程)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=21015, createdName=heli0118, createdTime=Tue Jan 10 15:07:00 CST 2017, time=2017-01-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1844498, encodeId=0f8a18444985b, content=<a href='/topic/show?id=5d2f206482e' target=_blank style='color:#2F92EE;'>#专家共识#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20648, encryptionId=5d2f206482e, topicName=专家共识)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=568152, createdName=snowpeakxu, createdTime=Fri Nov 11 16:07:00 CST 2016, time=2016-11-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=153169, encodeId=dfd415316946, content=非常有用！, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=196a1957900, createdName=1e12c380m39(暂无匿称), createdTime=Thu Nov 03 22:11:24 CST 2016, time=2016-11-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=141748, encodeId=0093141e4828, content=文章很棒，继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Sat Oct 08 08:36:41 CST 2016, time=2016-10-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=119109, encodeId=10cb11910999, content=关注，值得学习。赞！好文有待探究。, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Sat Sep 10 11:55:00 CST 2016, time=2016-09-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=98623, encodeId=94bb9862330, content=好好学习一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sun Aug 14 18:08:00 CST 2016, time=2016-08-14, status=1, ipAttribution=)]
    2016-09-10 amyloid

    #TORCH#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1968546, encodeId=e8481968546a8, content=<a href='/topic/show?id=a6541e664ae' target=_blank style='color:#2F92EE;'>#TORCH#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17664, encryptionId=a6541e664ae, topicName=TORCH)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=325a197, createdName=amyloid, createdTime=Sat Sep 10 02:07:00 CST 2016, time=2016-09-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2041934, encodeId=00a5204193492, content=<a href='/topic/show?id=d8684e896de' target=_blank style='color:#2F92EE;'>#工作流程#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47896, encryptionId=d8684e896de, topicName=工作流程)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=21015, createdName=heli0118, createdTime=Tue Jan 10 15:07:00 CST 2017, time=2017-01-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1844498, encodeId=0f8a18444985b, content=<a href='/topic/show?id=5d2f206482e' target=_blank style='color:#2F92EE;'>#专家共识#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20648, encryptionId=5d2f206482e, topicName=专家共识)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=568152, createdName=snowpeakxu, createdTime=Fri Nov 11 16:07:00 CST 2016, time=2016-11-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=153169, encodeId=dfd415316946, content=非常有用！, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=196a1957900, createdName=1e12c380m39(暂无匿称), createdTime=Thu Nov 03 22:11:24 CST 2016, time=2016-11-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=141748, encodeId=0093141e4828, content=文章很棒，继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Sat Oct 08 08:36:41 CST 2016, time=2016-10-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=119109, encodeId=10cb11910999, content=关注，值得学习。赞！好文有待探究。, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Sat Sep 10 11:55:00 CST 2016, time=2016-09-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=98623, encodeId=94bb9862330, content=好好学习一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sun Aug 14 18:08:00 CST 2016, time=2016-08-14, status=1, ipAttribution=)]
    2017-01-10 heli0118

    #工作流程#

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1968546, encodeId=e8481968546a8, content=<a href='/topic/show?id=a6541e664ae' target=_blank style='color:#2F92EE;'>#TORCH#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17664, encryptionId=a6541e664ae, topicName=TORCH)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=325a197, createdName=amyloid, createdTime=Sat Sep 10 02:07:00 CST 2016, time=2016-09-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2041934, encodeId=00a5204193492, content=<a href='/topic/show?id=d8684e896de' target=_blank style='color:#2F92EE;'>#工作流程#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47896, encryptionId=d8684e896de, topicName=工作流程)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=21015, createdName=heli0118, createdTime=Tue Jan 10 15:07:00 CST 2017, time=2017-01-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1844498, encodeId=0f8a18444985b, content=<a href='/topic/show?id=5d2f206482e' target=_blank style='color:#2F92EE;'>#专家共识#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20648, encryptionId=5d2f206482e, topicName=专家共识)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=568152, createdName=snowpeakxu, createdTime=Fri Nov 11 16:07:00 CST 2016, time=2016-11-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=153169, encodeId=dfd415316946, content=非常有用！, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=196a1957900, createdName=1e12c380m39(暂无匿称), createdTime=Thu Nov 03 22:11:24 CST 2016, time=2016-11-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=141748, encodeId=0093141e4828, content=文章很棒，继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Sat Oct 08 08:36:41 CST 2016, time=2016-10-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=119109, encodeId=10cb11910999, content=关注，值得学习。赞！好文有待探究。, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Sat Sep 10 11:55:00 CST 2016, time=2016-09-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=98623, encodeId=94bb9862330, content=好好学习一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sun Aug 14 18:08:00 CST 2016, time=2016-08-14, status=1, ipAttribution=)]
    2016-11-11 snowpeakxu

    #专家共识#

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1968546, encodeId=e8481968546a8, content=<a href='/topic/show?id=a6541e664ae' target=_blank style='color:#2F92EE;'>#TORCH#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17664, encryptionId=a6541e664ae, topicName=TORCH)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=325a197, createdName=amyloid, createdTime=Sat Sep 10 02:07:00 CST 2016, time=2016-09-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2041934, encodeId=00a5204193492, content=<a href='/topic/show?id=d8684e896de' target=_blank style='color:#2F92EE;'>#工作流程#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47896, encryptionId=d8684e896de, topicName=工作流程)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=21015, createdName=heli0118, createdTime=Tue Jan 10 15:07:00 CST 2017, time=2017-01-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1844498, encodeId=0f8a18444985b, content=<a href='/topic/show?id=5d2f206482e' target=_blank style='color:#2F92EE;'>#专家共识#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20648, encryptionId=5d2f206482e, topicName=专家共识)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=568152, createdName=snowpeakxu, createdTime=Fri Nov 11 16:07:00 CST 2016, time=2016-11-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=153169, encodeId=dfd415316946, content=非常有用！, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=196a1957900, createdName=1e12c380m39(暂无匿称), createdTime=Thu Nov 03 22:11:24 CST 2016, time=2016-11-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=141748, encodeId=0093141e4828, content=文章很棒，继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Sat Oct 08 08:36:41 CST 2016, time=2016-10-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=119109, encodeId=10cb11910999, content=关注，值得学习。赞！好文有待探究。, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Sat Sep 10 11:55:00 CST 2016, time=2016-09-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=98623, encodeId=94bb9862330, content=好好学习一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sun Aug 14 18:08:00 CST 2016, time=2016-08-14, status=1, ipAttribution=)]
    2016-11-03 1e12c380m39(暂无匿称)

    非常有用！

    0

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    2016-10-08 1e10c84am36(暂无匿称)

    文章很棒，继续学习

    0

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    2016-09-10 ylzr123

    关注，值得学习。赞！好文有待探究。

    0

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    2016-08-14 忠诚向上

    好好学习一下

    0