不同阴道灌洗方案对妇科良性肿瘤患者阴道微生态和舒适度的影响

发布时间：2018-01-10 04:25

本文关键词：不同阴道灌洗方案对妇科良性肿瘤患者阴道微生态和舒适度的影响　出处：《河北医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:观察不同阴道灌洗方案对患者阴道微生态和舒适度的影响,寻求最佳阴道灌洗方案,为临床护理工作提供理论依据。方法:选取2015年12月至2016年10月在河北省某三甲综合医院妇科180例良性肿瘤住院患者为研究对象,利用电脑EXCEL随机函数进行分组,随机分为试验一组,试验二组,试验三组,试验四组,试验五组,试验六组。在患者入院后,未做任何阴道检查前,取患者阴道分泌物,选取阴道菌群密度为Ⅲ-Ⅵ度的患者给予不同阴道灌洗方案进行阴道灌洗。采用两种阴道灌洗方式和灌洗液苯扎氯铵三种不同浓度组成六种阴道灌洗方案。两种阴道灌洗方式是:方式一:首先冲洗外阴,然后用左手分开小阴唇,将灌洗头沿阴道侧壁的方向缓慢插入阴道达阴道后穹隆,边冲洗边将灌洗头围绕子宫颈轻轻地上下左右移动;方式二:首先冲洗外阴,然后用左手分开小阴唇,用窥阴器暴露宫颈后灌洗头再插入阴道进行冲洗,边冲洗边左右旋转窥阴器。苯扎氯铵的三种不同阴道灌洗浓度分别为:0.02%;0.035%;0.05%。在灌洗前和灌洗后24小时分别取患者阴道分泌物进行菌群密度和pH值的检测。观察六组患者阴道灌洗前和灌洗后24小时的阴道菌群密度和pH值的变化以及灌洗过程中患者的舒适度。采用格兰染色法检测患者阴道分泌物,观察菌群密度。用pH精密试纸(上海三爱思试剂有限公司)检测患者阴道pH值。依据视觉模拟评分法(Visual Analogue Scale,VAS量表),评价患者的舒适度。将六组患者阴道灌洗前和灌洗后24小时的各项数据进行组内和组间的比较,舒适度进行组间比较。探讨六种不同的阴道灌洗方案对阴道菌群密度和pH值以及灌洗过程中患者舒适度的影响。采用SPSS19.0统计软件进行数据分析。结果:1六组患者基本特征六组患者在年龄(P=0.905)、阴道清洁度(P=0.991)等方面无统计学差异。2六组患者阴道灌洗前及灌洗后24小时阴道菌群密度的组内比较试验一组患者阴道菌群密度(P0.001),试验二组患者阴道菌群密度(P0.001),试验三组患者阴道菌群密度(P0.001),试验四组患者阴道菌群密度(P=0.001),试验五组患者阴道菌群密度(P=0.001),试验六组患者阴道菌群密度(P0.001),均有统计学差异。3六组患者阴道灌洗前及灌洗后24小时阴道菌群密度的组间比较阴道灌洗前,六组患者阴道菌群密度的组间比较(P=0.670)无统计学差异,阴道灌洗后24小时阴道菌群密度的组间比较(P=0.294)无统计学差异。4六组患者阴道灌洗前及灌洗后24小时阴道pH值的组内比较试验一组患者阴道pH值(P=0.066),试验二组患者阴道pH值(P=0.117),试验三组患者阴道pH值(P=0.211),试验四组患者阴道pH值(P=0.088),试验五组患者阴道pH值(P=0.150),试验六组患者阴道pH值(P=0.142),均无统计学差异。5六组患者中阴道灌洗前阴道pH值在3.8-4.5的患者阴道灌洗前及灌洗后24小时阴道pH值的组间比较阴道灌洗前,六组患者的阴道pH值的组间比较(P=0.782);阴道灌洗后24小时,六组患者阴道pH值的组间比较(P=0.456),均无统计学差异6六组患者阴道灌洗舒适度的组间比较6.1试验一组、试验三组、试验五组患者阴道灌洗舒适度的组间比较试验一组和试验三组(P=0.822),试验一组和试验五组(P=1.000),试验三组和试验五组(P=0.822),均无统计学差异。6.2试验二组、试验四组、试验六组患者阴道灌洗舒适度的组间比较试验二组和试验四组(P=0.261),试验二组和试验六组(P=0.339),试验四组和试验六组(P=0.866),均无统计学差异。6.3试验一组与试验二组、试验四组、试验六组患者阴道灌洗舒适度的组间比较试验一组和试验二组(P=0.001),试验一组和试验四组(P=0.019),试验一组和试验六组(P=0.012),均有统计学差异。6.4试验三组与试验二组、试验四组、试验六组患者阴道灌洗舒适度的组间比较试验三组和试验二组(P0.001),试验三组和试验四组(P=0.010),试验三组和试验六组(P=0.006),均有统计学差异。6.5试验五组与试验二组、试验四组、试验六组患者阴道灌洗舒适度的组间比较试验五组和试验二组(P=0.001),试验五组和试验四组(P=0.019)试验五组和试验六组(P=0.012),均有统计学差异。6.6试验二组与试验一组、试验三组、试验五组患者阴道灌洗舒适度的组间比较试验二组和试验一组(P=0.001),试验二组和试验三组(P0.001),试验二组和试验五组(P=0.001),均有统计学差异。6.7试验四组与试验一组、试验三组、试验五组患者阴道灌洗舒适度的组间比较试验四组和试验一组(P=0.019),试验四组和试验三组(P=0.010),试验四组和试验五组(P=0.019),均有统计学差异。6.8试验六组与试验一组、试验三组、试验五组患者阴道灌洗舒适度的组间比较试验六组和试验一组(P=0.012),试验六组和试验三组(P=0.006),试验六组和试验五组(P=0.012),均有统计学差异。结论:阴道灌洗可以使阴道菌群密度减小,改变阴道微生态环境。两种阴道灌洗方式对阴道菌群密度和pH值的影响无差异。不同浓度的苯扎氯铵溶液对阴道菌群密度和pH值的影响也无差异。苯扎氯铵是一种安全、刺激性小的消毒液。舒适度比较中,不使用窥阴器打开阴道暴露宫颈,直接使用一次性灌洗头进行阴道灌洗时,病人感觉更舒适。从病人舒适的角度出发,建议直接使用一次性灌洗头进行阴道灌洗,提高病人的依从性和护士的工作效率。
[Abstract]:Objective: To observe the effect of vaginal lavage on patients with vaginal micro ecological effects of scheme and comfort, to seek the best vaginal lavage and provide a theoretical basis for the scheme, clinical nursing. Methods: from December 2015 to October 2016 in a general hospital of Department of gynaecology in Hebei Province in 180 cases of benign tumor patients as the research object, using the computer random function of EXCEL group. Were randomly divided into experimental group, experimental group two, experimental group three, experimental group four, experimental group five, experimental group. In six patients after admission, did not do any vaginal examination before taking vaginal secretions, selection of vaginal flora density III - VI of patients treated with different vaginal lavage for vaginal lavage solution two. The vaginal lavage lavage fluid and benzalkonium chloride concentration of three different composition of six types of vaginal lavage scheme. Two kinds of vaginal lavage way: one way: first wash the vulva, and then use the The left hand from the labia minora, the irrigation head along the direction of the vaginal wall slowly inserted into the vagina of the vaginal vault, while washing side of the irrigation head around the cervix gently move up and down; two ways: first wash the vulva, and then use the left hand from the labia minora, with vaginal cervical irrigation head again after exposure were inserted into the vagina flushing, edge flush edge rotation around the speculum. The three different vaginal lavage concentrations of benzalkonium chloride respectively: 0.02%; 0.035%; 0.05%. in the lavage before and after lavage for 24 hours were collected from vaginal secretions of patients with bacteria density and pH values of the samples were observed for 24 hours. The vaginal flora density and pH value six groups of patients with vaginal lavage before and after lavage and lavage in comfort. The Glenn staining method to detect vaginal secretions, observe the bacterial density. With pH precision test paper (Shanghai san'aisi Reagent Co., Ltd) detection Patients with vaginal pH value. According to the visual analogue scale (Visual Analogue Scale, VAS), to evaluate the comfort of patients. The six groups of patients before and after vaginal lavage lavage the data 24 hours were compared between and within groups, were compared between the two groups of patients with comfort. Six different vaginal lavage scheme on vagina flora density and pH value in the process of comfort and lavage effect. Data were analyzed by SPSS19.0 statistical software. Results: the 1 basic characteristics of six groups of patients in the six groups in age (P=0.905), vaginal cleanliness test (P=0.991) is a group of patients with vaginal flora density 24 hours of vaginal bacteria the population density within the group, no significant difference between the.2 six groups of patients with vaginal lavage before and after lavage (P0.001) test, two groups of patients with vaginal flora density (P0.001) test, three groups of patients with vaginal flora density (P0.001) test, four groups of patients with vaginal flora Density (P=0.001) test, five groups of patients with vaginal flora density (P=0.001) test, six groups of patients with vaginal flora density (P0.001), there were statistically significant differences between the six groups of.3 patients with vaginal lavage before and after lavage 24 hours of vaginal flora density between the two groups before vaginal lavage, six groups of patients with vaginal flora density the comparison between the two groups had no statistical difference (P=0.670), vaginal lavage 24 hours after vaginal flora density between the two groups (P=0.294) 24 hour vaginal pH value had no significant difference in six groups of.4 patients with vaginal lavage before and after lavage group comparison test of a group of patients with vaginal pH value (P=0.066), test group two. Patients with vaginal pH value (P=0.117) test, three groups of patients with vaginal pH value (P=0.211) test, four groups of patients with vaginal pH value (P=0.088) test, five groups of patients with vaginal pH value (P=0.150) test, six groups of patients with vaginal pH value (P=0.142), there was no significant difference in six groups of.5 patients before vaginal lavage Yin PH value in 24 hours of vaginal vaginal pH value in patients with vaginal lavage 3.8-4.5 before and after lavage lavage group, compared six groups of patients with vaginal pH value between groups (P=0.782); 24 hours after vaginal lavage, compared six groups of patients with vaginal pH group (P=0.456), there was no statistical learn the difference between the 6 groups of patients with vaginal lavage six comfort groups 6.1 test group, test group three, test group five patients with vaginal lavage comfort comparison between groups of test group and test group three (P=0.822), a test group and test group five (P=1.000), test group three and test group five (P=0.822,.6.2) were no significant difference between the test group two, test group four and test group six patients with vaginal lavage comfort comparison between groups of test group two and test group four (P=0.261), test group two and test group six (P=0.339), test group four and test group six (P=0.866), there were no the statistical differences between the.6.3 group and a test The test group two, test group four and test group six patients with vaginal lavage comfort comparison between groups of test group and test group two (P=0.001), a test group and test group four (P=0.019), a test group and test group six (P=0.012), there were statistically significant differences between the.6.4 test group three and test group two four, the test group, the test group six patients with vaginal lavage comfort comparison between groups of test group three and test group two (P0.001), test group three and test group four (P=0.010), test group three and test group six (P=0.006), there were statistically significant differences between the.6.5 test group five and test group two, test the four test group, six groups of patients with vaginal lavage comfort comparison between groups of test group five and test group two (P=0.001), test group five and test group four (P=0.019) test group five and test group six (P=0.012), there were statistically significant differences between the.6.6 test group two and test group, test group three, test five groups of patients with vaginal lavage The comfort of comparison between groups of test group two and test group (P=0.001), test group two and test group three (P0.001), test group two and test group five (P=0.001), there were statistically significant differences between the.6.7 test group four and test group, test group three and test group five patients with vaginal lavage comfort comparison between groups of test group four and test group (P=0.019), test group four and test group three (P=0.010), test group four and test group five (P=0.019), there were statistically significant differences between the.6.8 test group six and test group, test group three and test group five patients with vaginal lavage comfort between the two groups the test group six and test group (P=0.012), test group six and test group three (P=0.006), test group six and test group five (P=0.012), there was significant difference. Conclusion: vaginal lavage can make the vaginal flora density decreased, change vaginal microecological environment. Two kinds of vaginal bacterial vaginal lavage the population density and pH No difference in value. There was no difference in the effect of different concentrations of Benzalkonium Chloride Solution on vagina flora density and pH value. Benzalkonium chloride is a safe and stimulating disinfectant small comfort. In comparison, do not use vaginal speculum open exposure cervix, direct use of disposable lavage head for vaginal lavage, the patient feels more comfortable. Starting from the comfort of the patient, it is recommended to use disposable lavage head for vaginal lavage, improve patient compliance and the work efficiency of nurses.

【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.73

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