825例下生殖道感染类型分析及其混合性感染的治疗研究

发布时间：2018-03-14 15:36

本文选题：单一阴道炎　切入点：混合性阴道炎　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:了解门诊女性下生殖道感染类型的构成情况,进而了解混合性阴道炎和混合宫颈炎的比例。探讨阴道混合感染同时针对性用药与临床逐一治疗的临床效果比较。方法:选取2015-12到2016-12山西大医院妇科门诊经临床表现和实验室检查确诊的825例下生殖道感染患者为研究对象。对其年龄、月经情况、就诊原因等一般资料进行收集,并对每例患者常规行妇科检查,观察白带的量、颜色和性状,宫颈口周围是否有炎性分泌物分布。两根棉拭子均蘸取阴道侧壁上1/3的分泌物,一份用于阴道pH检测,另一份用于实验室检查(盐水湿片及革兰染色检查),观察内容包括白细胞数量、上皮细胞、有无滴虫、线索细胞、孢子、菌丝、乳杆菌,阴道菌群及阴道清洁度的测定。本课题研究我院妇科门诊825例下生殖道感染类型的构成情况及混合感染的比例。对混合性阴道炎患者(BV+VVC、AV+BV),采用同时针对性治疗与模拟临床上逐一治疗对照,比较两种治疗的有效率。结果:1.825例下生殖道感染中,单一阴道炎占59.03%(487/825),混合感染占40.97%(338/825)。2.单一阴道炎以BV居多,197例(40.45%),其次是VVC 143例(29.36%),再者是AV 101例(20.74%),TV 43例(8.83%),CV最少,3例(0.62%)。3.下生殖道混合感染中,最常见的混合类型是BV+VVC,93例(27.51%),其次是BV+AV 86例(25.44%),再者依次是VVC+AV 34例(10.06%)、BV+TV 32例(9.47%)、AV+TV 30例(8.88%)、BV+TV+AV 27例(7.99%)、AV+BV+VVC 15例(4.44%),BV+VVC+TV最少,8例(2.37%)。混合宫颈炎13例(3.85%)。4.BV+VVC感染的90例患者,随机分为对照组45例(氟康唑0.15g,第1、4天两日疗法)和研究组45例(氟康唑0.15g,第1、4天两日疗法+甲硝唑阴道泡腾片0.4g/晚×7天)。两种方法治疗BV+VVC有效率比较差异有统计学意义(P0.05)。即氟康唑+甲硝唑阴道泡腾片联合治疗的有效率(95.56%)高于单用氟康唑(71.11%)。5.AV+BV感染的80例患者,随机分为对照组40例(甲硝唑片0.4g 2次/日×7天)和研究组40例(甲硝唑片0.4g 2次/日×7天+克林霉素磷酸酯阴道凝胶1支/晚(5g)×6天)。两种方法治疗AV+BV有效率比较差异有统计学意义(P0.05)。即甲硝唑+克林霉素磷酸酯阴道凝胶联合治疗的有效率(95.0%)高于单用甲硝唑(52.5%)。结论:1.下生殖道感染中混合性感染占较高比例(包括宫颈炎),临床诊断应全面准确。2.下生殖道混合感染,进行同时针对性治疗优于逐一治疗。
[Abstract]:Objective: to investigate the types of lower genital tract infection in outpatients. In order to understand the proportion of mixed vaginitis and mixed cervicitis, to explore the clinical effects of combined vaginal infection and clinical treatment. Methods: select 2015-12 to 2016-12 Shanxi Hospital gynecological outpatient clinic clinical results. The age of 825 patients with lower genital tract infection confirmed by clinical manifestation and laboratory examination was studied. General data such as menstruation, reasons for seeing a doctor and so on were collected, and gynecological examinations were performed on each patient to observe the quantity, color and character of leucorrhea. Whether or not inflammatory secretions are distributed around the cervix. Both cotton swabs are dipped in 1/3 of the vaginal secretions on the lateral wall of the vagina, and one part is used to detect vaginal pH. The other was used for laboratory tests (saline wet tablets and Gram staining) for white blood cell count, epithelial cells, trichomonas, clue cells, spores, hyphae, lactobacillus, Determination of vaginal flora and vaginal cleanliness. This subject is to study the composition of lower genital tract infection type and the proportion of mixed infection in 825 cases of gynecological outpatient in our hospital. The patients with mixed vaginitis were treated with BV VVCU AV BV BVV at the same time. As compared with the simulated clinical treatment one by one, Results in 1. 825 cases of lower genital tract infection, Single vaginitis accounted for 59.03487 / 825, mixed infections 40.97 / 825.2.The single vaginitis were mainly BV in 197 cases, followed by VVC in 14.3 cases, followed by VVC #number0# cases, followed by AV 101 cases with 20.74TV, 43 cases with 8.83ACV, with the least 3 cases with 0.622.3.In the lower genital tract infection, The most common type of mixing was BV VVCV in 93 cases, BV AV in 86 cases, BV AV in 86 cases, and BV in turn, followed by VVC AV in 34 cases, BV TV in 32 cases and BV TV in 30 cases, in which there were 30 cases of BV AV and 30 cases of BV VV, 27 cases of BV VV AV, 27 cases of BV BV VVC, 15 cases of BV BV VVC, 15 cases of BV BV VVC TV, 15 cases of BV AV, 15 cases of BV VVC TV, 15 cases of BV AV, 15 cases of BV AV, 15 cases of BV VVC TV, 15 cases of BV AV, 15 cases of BV VVC TV, 15 cases of BV AV, 15 cases of BV AV, 15 cases of BV VVC TV, 15 cases of BV AV, They were randomly divided into two groups: the control group (n = 45) (fluconazole 0.15g) and the study group (n = 45) (fluconazole 0.15g) and the study group (n = 45). The effective rate of metronidazole vaginal effervescent tablets was 0.4g / night 脳 7d. There was a significant difference between the two methods in the treatment of BV VVC. The effective rate of fluconazole metronidazole vaginal effervescent tablet was 95.56), which was higher than that of 80 patients with BV infection of fluconazole alone 71.110.5.AV BV infection rate was higher than that of fluconazole metronidazole vaginal effervescent tablet alone. They were randomly divided into control group (n = 40) (metronidazole tablet 0.4g / d 脳 7 days) and study group (n = 40) (metronidazole tablet 0.4g / d 脳 7 days) 脳 6 days. The difference was statistically significant (P 0.05). That is, the effective rate of metronidazole clindamycin phosphate vaginal gel was 95.0% higher than that of metronidazole alone 52.5%. Conclusion: 1. Mixed infections (including cervicitis) are higher in lower genital tract infection than in metronidazole alone. Clinical diagnosis should be comprehensive and accurate .2. mixed infection of lower genital tract, Simultaneous targeted therapy is better than one treatment.
【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】：R711.3

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