504例人工流产患者术前阴道微生态结果分析
发布时间：2019-05-10 12:23
【摘要】：目的:分析人工流产患者术前阴道微生态结果,探讨阴道微生态评估在人工流产术前的临床应用价值,了解阴道微生态的临床应用现状。方法:1.收集2016年10月-2017年1月于重庆医科大学附属第二医院门诊行人工流产的504例患者阴道分泌物,进行阴道微生态评估及临床症状分析。2.通过对部分妇产科医生进行调查问卷,了解阴道微生态应用现状及医务人员对阴道微生态的知晓度。结果:1.504例阴道微生态评估结果显示:微生态正常214例(42.5%),微生态异常290例(57.5%);在290例阴道微生态异常中:阴道炎症120例(120/290),阴道微生态失衡170例(170/290)。在120例阴道炎症中:清洁度异常32例(6.3%)、外阴阴道假丝酵母菌病(vulvovaginal candidiasis,VVC)51例(10.1%),细菌性阴道病(bacterial vaginosis,BV)29例(5.8%),混合感染8例(1.6%),其中BV和VVC混合感染7例(1.4%),BV和滴虫性阴道炎(trichomonal vaginitis,TV)混合感染1例(0.2%);在170例阴道微生态失衡中:PH值异常38例(7.5%)、乳杆菌数目异常162例(32.4%)、乳杆菌功能异常60例(11.9%)、优势菌异常161例(31.9%)、菌群抑制9例(1.8%)。2.290例阴道微生态异常菌群功能学结果:1)过氧化氢阳性共115例:BV4例(13.8%4/29),VVC45例(88.2%45/51),混合感染8例(100%),清洁度异常15例(46.9%15/32),ph异常33例(86.8%33/38),乳杆菌数目异常56例(34.6%56/162),乳杆菌功能异常60例(100%),优势菌异常59例(36.6%59/161),菌群抑制1例(11.1%1/9);2)白细胞酯酶阳性共120例:bv29例(100%),vvc51例(100%),混合感染8例(100%),清洁度异常20例(62.5%20/32),ph异常7例(18.4%7/38),乳杆菌数目异常13例(8%13/162),乳杆菌功能异常9例(15%9/60),优势菌异常14例(8.7%14/161),菌群抑制0例;3)唾液酸苷酶阳性共32例:bv29例(100%),vvc0例,混合感染6例(75%6/8),清洁度异常2例(6.2%2/8),ph异常1例(2.6%1/38),乳杆菌数目异常1例(0.6%1/162),乳杆菌功能异常1例(1.7%1/60),优势菌异常1例(0.6%1/161),菌群抑制0例。3.290例阴道微生态异常患者中,无临床症状患者186例(64.1%186/290),包括70例阴道炎症、116例阴道微生态失衡;有临床症状患者104例(35.9%104/290)包括50例阴道炎症、54例阴道微生态失衡,临床症状包括白带异常(白带增多、异味及颜色异常)98例,外阴瘙痒82例,外阴灼痛26例。4.对154名妇产科医生进行阴道微生态现状调查问卷结果显示:119名医生对阴道微生态知晓(77.3%),余下35名(22.7%)医生对阴道微生态表示不了解。119名对阴道微生态知晓的医生中有116人(97.5%116/119)认为阴道微生态对于阴道感染性疾病的诊治具有临床指导意义。5.在问卷调查中大多数妇产科医生认为:阴道炎症重、反复阴道感染的患者应该进行阴道微生态评估;阴道炎用药后随访患者应行阴道微生态评估;阴道微生态评估提示微生态失调时应短期动态观察微生态变化情况。结论:阴道微生态评估能够发现人工流产患者术前阴道炎症及微生态失衡状态,人工流产患者因机体内分泌改变容易发生阴道微生态失衡,临床医生应重视人工流产患者术前阴道微生态评估。目前大部分临床妇产科医生(116/154)能够明确阴道微生态概念及临床意义且能合理地运用阴道微生态评估。
[Abstract]:Objective: To analyze the microecological results of the pre-operative vaginal microecology in the patients with induced abortion, and to study the clinical application value of the vaginal microecological assessment before and after induced abortion and to understand the clinical application of the microecology of the vagina. Method:1. The vaginal discharge of 504 patients with artificial abortion in the second hospital of Chongqing Medical University was collected from October 2016 to January 2017, and the vaginal microecological assessment and the clinical symptom analysis were performed. The present situation of the microecological application of the vagina and the awareness of the medical staff on the microecology of the vagina were studied by the questionnaire of some obstetricians and obstetrics doctors. Results: 1.504 cases of vaginal microecological assessment showed that the microecological normal 214 cases (42.5%) and the micro-ecological abnormality in 290 cases (57.5%); in 290 vaginal microecological abnormalities:120 cases (120/290) of vaginal inflammation and 170 cases (170/290) of microecological imbalance in the vagina. In 120 cases of vaginal inflammation, the cleanliness was abnormal in 32 (6.3%), vulvovaginal candidiasis (VVC) in 51 (10.1%), bacterial vaginosis (BV) in 29 (5.8%), and mixed infection in 8 (1.6%), of which BV and VVC were mixed in 7 cases (1.4%). BV and trichomonas vaginitis (TV) mixed infection in 1 case (0.2%); in 170 cases of vaginal microecological imbalance: the PH value was abnormal 38 (7.5%), the number of lactobacilli was 162 (32.4%), the function of Lactobacillus was abnormal in 60 (11.9%), and the dominant bacteria were abnormal in 161 (31.9%). The microflora of the vagina was inhibited in 9 cases (1.8%). 2.290 cases of vaginal microecological abnormal microflora (1) hydrogen peroxide positive in 115 patients: BV4 (13.8%4/29), VVC45 (88.2%45/51), mixed infection in 8 (100%), cleanliness abnormality in 15 (46.9%15/32), ph abnormal 33 (86.8%33/38), There were 56 cases (34.6%56/162),60 (100%),59 (36.6%59/161),1 (11.1%1/9), and 1 (100%), and 8 (100%) mixed infection, in which the number of lactobacilli was abnormal (34.6%56/162), the function of Lactobacillus was 60 (100%), the dominant bacteria were abnormal in 59 (36.6%59/161), and the flora was inhibited in one case (11.1%1/9);2) the white blood cell esterase was positive in 120 cases: bv29 (100%), vvc51 (100%), and mixed infection in 8 cases (100%). The cleanliness was abnormal in 20 cases (62.5%20/32), the ph was abnormal in 7 (18.4%7/38), the number of lactobacilli was 13 (8%13/162), the function of the lactobacillus was abnormal in 9 (15%9/60), the dominant bacteria were abnormal in 14 (8.7%14/161), the flora inhibited 0,3) the positive total of the sialyl was 32: bv29 (100%), vvc0, 6 cases (75%6/8) of mixed infection,2 cases (6.2%2/8),1 case (2.6%1/38),1 case (0.6%1/162),1 case (1.7%1/60) of lactobacillus,1 case (0.6%1/161) of dominant bacteria and 0 cases of microflora. 186 patients with no clinical symptoms (64.1%186/290), including 70 vaginal inflammation and 116 vaginal microecological imbalance;104 (35.9%104/290) of the patients with clinical symptoms included 50 vaginal inflammation,54 vaginal microecological imbalances, clinical symptoms including white-band abnormalities (white-band increase, off-flavor, and color abnormalities) of 98, The vulvar itching was 82 cases, and the vulvar burning pain was 26 cases. The results of the survey of the vaginal microecological status of 154 obstetricians and gynaecologists showed that 119 doctors were aware of the microecology of the vagina (77.3%). The remaining 35 (22.7%) doctors did not know about the microecology of the vagina. Of the 119,116 (97.5%116/119) of the 119 microecological know-how, the vaginal microecology has a clinical guiding significance for the diagnosis and treatment of the vaginal infectious diseases. In the questionnaire, most of the obstetricians of the department of obstetrics and gynecology considered that the vaginal microecological assessment should be carried out in the patients with severe vaginal inflammation and recurrent vaginal infections, and the follow-up patients should be followed up for vaginal microecological assessment after the treatment of vaginitis; The microecological change of the microecological imbalance should be observed in short-term in the microecological assessment of the vagina. Conclusion: The vaginal microecological assessment can find the pre-operative vaginal inflammation and microecological imbalance in the patients with induced abortion. At present, most of the clinical obstetrics and gynecology doctors (116/154) can define the concept and clinical significance of the vaginal microecology and can reasonably use the vaginal microecological assessment.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R169.42
本文编号：2473645
[Abstract]:Objective: To analyze the microecological results of the pre-operative vaginal microecology in the patients with induced abortion, and to study the clinical application value of the vaginal microecological assessment before and after induced abortion and to understand the clinical application of the microecology of the vagina. Method:1. The vaginal discharge of 504 patients with artificial abortion in the second hospital of Chongqing Medical University was collected from October 2016 to January 2017, and the vaginal microecological assessment and the clinical symptom analysis were performed. The present situation of the microecological application of the vagina and the awareness of the medical staff on the microecology of the vagina were studied by the questionnaire of some obstetricians and obstetrics doctors. Results: 1.504 cases of vaginal microecological assessment showed that the microecological normal 214 cases (42.5%) and the micro-ecological abnormality in 290 cases (57.5%); in 290 vaginal microecological abnormalities:120 cases (120/290) of vaginal inflammation and 170 cases (170/290) of microecological imbalance in the vagina. In 120 cases of vaginal inflammation, the cleanliness was abnormal in 32 (6.3%), vulvovaginal candidiasis (VVC) in 51 (10.1%), bacterial vaginosis (BV) in 29 (5.8%), and mixed infection in 8 (1.6%), of which BV and VVC were mixed in 7 cases (1.4%). BV and trichomonas vaginitis (TV) mixed infection in 1 case (0.2%); in 170 cases of vaginal microecological imbalance: the PH value was abnormal 38 (7.5%), the number of lactobacilli was 162 (32.4%), the function of Lactobacillus was abnormal in 60 (11.9%), and the dominant bacteria were abnormal in 161 (31.9%). The microflora of the vagina was inhibited in 9 cases (1.8%). 2.290 cases of vaginal microecological abnormal microflora (1) hydrogen peroxide positive in 115 patients: BV4 (13.8%4/29), VVC45 (88.2%45/51), mixed infection in 8 (100%), cleanliness abnormality in 15 (46.9%15/32), ph abnormal 33 (86.8%33/38), There were 56 cases (34.6%56/162),60 (100%),59 (36.6%59/161),1 (11.1%1/9), and 1 (100%), and 8 (100%) mixed infection, in which the number of lactobacilli was abnormal (34.6%56/162), the function of Lactobacillus was 60 (100%), the dominant bacteria were abnormal in 59 (36.6%59/161), and the flora was inhibited in one case (11.1%1/9);2) the white blood cell esterase was positive in 120 cases: bv29 (100%), vvc51 (100%), and mixed infection in 8 cases (100%). The cleanliness was abnormal in 20 cases (62.5%20/32), the ph was abnormal in 7 (18.4%7/38), the number of lactobacilli was 13 (8%13/162), the function of the lactobacillus was abnormal in 9 (15%9/60), the dominant bacteria were abnormal in 14 (8.7%14/161), the flora inhibited 0,3) the positive total of the sialyl was 32: bv29 (100%), vvc0, 6 cases (75%6/8) of mixed infection,2 cases (6.2%2/8),1 case (2.6%1/38),1 case (0.6%1/162),1 case (1.7%1/60) of lactobacillus,1 case (0.6%1/161) of dominant bacteria and 0 cases of microflora. 186 patients with no clinical symptoms (64.1%186/290), including 70 vaginal inflammation and 116 vaginal microecological imbalance;104 (35.9%104/290) of the patients with clinical symptoms included 50 vaginal inflammation,54 vaginal microecological imbalances, clinical symptoms including white-band abnormalities (white-band increase, off-flavor, and color abnormalities) of 98, The vulvar itching was 82 cases, and the vulvar burning pain was 26 cases. The results of the survey of the vaginal microecological status of 154 obstetricians and gynaecologists showed that 119 doctors were aware of the microecology of the vagina (77.3%). The remaining 35 (22.7%) doctors did not know about the microecology of the vagina. Of the 119,116 (97.5%116/119) of the 119 microecological know-how, the vaginal microecology has a clinical guiding significance for the diagnosis and treatment of the vaginal infectious diseases. In the questionnaire, most of the obstetricians of the department of obstetrics and gynecology considered that the vaginal microecological assessment should be carried out in the patients with severe vaginal inflammation and recurrent vaginal infections, and the follow-up patients should be followed up for vaginal microecological assessment after the treatment of vaginitis; The microecological change of the microecological imbalance should be observed in short-term in the microecological assessment of the vagina. Conclusion: The vaginal microecological assessment can find the pre-operative vaginal inflammation and microecological imbalance in the patients with induced abortion. At present, most of the clinical obstetrics and gynecology doctors (116/154) can define the concept and clinical significance of the vaginal microecology and can reasonably use the vaginal microecological assessment.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R169.42
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