需氧菌阴道炎的临床特征及其影响因素的临床研究

发布时间：2018-03-03 23:24

本文选题：需氧菌阴道炎　切入点：混合感染　出处：《山西医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:探讨需氧菌阴道炎(Aerobic Vaginitis,AV)的临床特征及其影响因素,为AV的临床诊治提供依据。方法:选取2016年4月-2016年12月在山西医科大学第一医院、临汾市人民医院、晋煤大医院妇科门诊就诊的516例AV患者为研究对象。对阴道分泌物行细菌培养,统计AV的感染状况,并记录AV的临床特征及分析其可能的影响因素。结果:(1)在516例患者中,年龄20岁者有30例(5.81%,30/516),21-30岁者有201例(38.95%,201/516),31-40岁者156例(30.23%,156/516),41-50岁者75例(14.53%,75/516),51-60岁者33例(6.39%,33/516),60岁者21例(4.07%,21/516);(2)516例共有508例培养出细菌,8例未培养出细菌,其中一种致病原为487例,多种致病原21例。单一病原中居前三位的是大肠杆菌166例(34.1%)、金黄色葡萄球菌111例(22.8%)和β溶血性链球菌75例(15.4%),而混合菌种中主要为大肠杆菌+金黄色葡萄球菌9例;(3)AV单一感染327例,占比63.4%,AV混合感染189例,占比36.6%;(4)AV单一感染和混合感染在外阴瘙痒(（？）=1.99,P=0.16)、白带异常(（？）=0.90,P=0.34)方面比较差异无统计学意义,而单一感染和混合感染在灼痛(（？）=44.01,P0.01)、黏膜充血(（？）=77.45,P0.01)、清洁度(（？）=26.63,P0.01)、乳酸杆菌(（？）=77.49,P0.01)及阴道分泌物PH值(（？）=38.15,P0.01)有关;(5)AV混合感染与年龄(（？）=21.82,P0.01)、教育程度(（？）=24.25,P0.01)、经常出差(（？）=30.91,P0.01)、性伴侣个数(（？）=8.39,P0.01)、性生活史(（？）=8.39,P0.01)及安全套避孕(（？）=9.29,P0.01)相关,而与吸烟(（？）=1.29,P=0.25)、饮酒(（？）=1.18,P=0.28)及阴道冲洗习惯(（？）=0.31,P=0.58)无明显相关性。结论:(1)在AV患者中,育龄期妇女多见;(2)AV感染可由一种或多种需氧菌致病,最常见致病菌为大肠杆菌;(3)AV混合感染常见,其中与细菌性阴道病(Bacterial vaginosis,BV)混合多见;(4)AV混合感染患者更多表现为阴道灼痛、黏膜充血、乳酸杆菌少、清洁度差及PH偏高;(5)AV混合感染与年龄、教育程度、经常出差、性伴侣个数、性生活史及避孕套避孕相关,而与吸烟、饮酒及阴道冲洗习惯无明显相关性。
[Abstract]:Objective: to investigate the clinical characteristics and influencing factors of Aerobic VaginitisAV (AVV) in order to provide the basis for clinical diagnosis and treatment of AV. Methods: select the first Hospital of Shanxi Medical University from April 2016 to December 2016, Linfen people's Hospital. 516 cases of AV patients in gynecological outpatient clinic of Shanxi Coal University Hospital were studied. The bacterial culture of vaginal secretions was carried out, the infection status of AV was recorded, and the clinical characteristics of AV were recorded and the possible influencing factors were analyzed. There were 30 people of 20 years of age, 30 / 516 / 21-30 years old, 201 cases with 38.95 / 201516 / 40 years old, 156 cases with 30.23 156 / 516 / 50 years old, 75 cases with 14.53 / 51651-60 years old, 33 cases with 6.393333 / 516% / 60 year old, 21 cases with 6.393333516 / 60 year old 21 / 21 516 / 2516 cases with a total of 508 cases of uncultured bacteria, of which there were 487 cases of uncultured bacteria. Among the 21 cases of multiple pathogens, 166 cases of Escherichia coli were in the top 3, 111 cases of Staphylococcus aureus were 22. 8%) and 75 cases of 尾 -hemolytic streptococcus were 15. 4%, while 9 cases of mixed bacteria were Escherichia coli Staphylococcus aureus. There were 327 cases of single infection of AV. There were 189 cases of mixed infection of AV in 63.4%, 36.6% of single infection of AV and mixed infection of AV in vulva pruritus? Is 1. 99 Pu 0.16??? There was no statistical difference between 0.90 and 0.34), but single infection and mixed infection had no statistical significance. 44.01U P0.01A, mucosal congestion? P0.01C, 77.45m, cleanliness? P0.01A 26.63%, Lactobacillus lactis? P0.01) and the PH value of vaginal secretion? AV mixed infection and age? 21. 82% P0. 01, educational level? Do you often travel on business? Do you have 30.91U P0.01a, and how many sexual partners do you have? Do you have a life history of 8. 39% P0. 01? P0.01) and condom contraception??? (P 0.01), but related to smoking? Do you have 1. 29??? (1. 18 / 0. 28) and vaginal washing habits? Conclusion: in patients with AV, AV infection is more common in women of childbearing age than that in women of childbearing age. AV infection can be caused by one or more aerobic bacteria, and the most common pathogenic bacteria is Escherichia coli. Among them, patients mixed with bacterial vaginosism (BV) were more likely to have vaginal burns, congestion of mucous membrane, less lactobacillus, poor cleanliness and high PH, mixed infection with age, education, frequent travel, and number of sexual partners. Sexual history and condom contraception were not correlated with smoking, drinking and vaginal washing.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R711.31

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