女性下生殖道性传播病原体感染与输卵管妊娠发生及术后输卵管通畅的相关性研究

发布时间：2018-04-10 02:13

本文选题：性传播疾病病原体　切入点：输卵管妊娠　出处：《暨南大学》2011年硕士论文

【摘要】：试验目的：了解我院输卵管妊娠患者下生殖道性传播疾病病原体分布情况,并对解脲支原体药敏结果进行分析,探讨本地区女性下生殖道感染的病原微生物与输卵管妊娠的关系,为临床治疗提供用药依据,减少病原体迁延感染,降低输卵管妊娠再发生率。材料和方法：对135例输卵管妊娠者(研究组)和68例卵巢囊肿、子宫肌瘤患者(对照组)宫颈分泌物进行性传播疾病(STD)病原体检测、分析,对解脲支原体阳性者进行药敏试验；并对其临床病史资料、术中情况和术后输卵管病理资料进行分析；于术后三个月行子宫输卵管碘油造影(hystero-salpingogram, HSG),了解输卵管再通情况。结果： 1.135例输卵管妊娠患者中,沙眼衣原体(CT)检出率为19.3%(26/135),解脲支原体(UU)检出率为40.7%(55/135),CT和UU混合感染率为8.9%(12/135),淋病奈瑟菌(NG)检出率为3.7%(5/135)；对照组68例患者中,CT检出率4.4%(3/68),UU检出率17.6%(12/68),CT+UU混合感染和NG检出率均为0(0/68)；两组CI、UU、CT+UU混合感染检出率有显著性差异,X2值分别为8.1,10.9和4.9,P值分别为0.004,0.001和0.026； 2.两次以上输卵管妊娠患者CT和CT+UU检出率为34.8%和21.7%,均明显高于初次输卵管妊娠患者,X2值分别为4.3和5.7,P值分别为0.038和0.017； 3.解脲支原体感染对药物的敏感性不同,UU对强力霉素、交沙霉素、克拉霉素较敏感,对氧氟沙星和罗红霉素有较高的耐药率； 4.CT和UU阳性输卵管妊娠患者术中见盆腔粘连比例分别高达80.8%和76.4%；研究组送检的输卵管组织炎症病理改变患者和术中见输卵管形态异常患者比例分别为84.4%和80.7%,明显高于对照组,X2值分别为112和95,P值均为0.000； 5.25例CT和UU感染的输卵管妊娠患者术后3个月输卵管再通情况：UU感染再通率77.8%(14/18),CT感染再通率57.1%(4/7),两者无显著性差异(X2=1.1：P=0.355)。结论： 1.性传播疾病与输卵管妊娠的发生有关；其病原体主要是沙眼衣原体(CT)与解脲支原体(UU),淋球菌感染病例很少； 2.输卵管妊娠的输卵管呈慢性炎性改变；正规治疗后随访术后三个月,大部分患者的输卵管可以恢复通畅; 3.把性传播疾病病原体的检测作为异位妊娠的常规检查项目,有助于确定病原体的类型。
[Abstract]:The purpose of the experiment was:To understand the distribution of pathogens of sexually transmitted diseases in the lower genital tract in our hospital, and to analyze the drug sensitivity of Ureaplasma Urealyticum, and to explore the relationship between the pathogenic microorganisms of female lower genital tract infection and tubal pregnancy.To provide the basis for clinical treatment, reduce the pathogen delayed infection, reduce the incidence of tubal pregnancy.Materials and methods:The pathogens of STD in 135 cases of tubal pregnancy (study group) and 68 cases of ovarian cyst and hysteromyoma (control group) were detected and analyzed.The clinical history, intraoperative and postoperative pathological data of fallopian tube were analyzed, and hystero-salpingogram-hystero-salpingogramma (HSGG) was performed three months after operation to understand the recanalization of fallopian tube.Results:Of the 1.135 cases of tubal pregnancy,There was a significant difference in the detection rate of UU CT UU mixed infection between the two groups (X _ 2 = 8.1 卤10.9 and P = 4.9P = 0.004 / 0. 001 and 0. 026, respectively), and there was significant difference between the two groups in the detection rate of UU / UU mixed infection (P < 0. 01 / 68).2.The detectable rates of CT and CT UU were 34.8% and 21.7%, respectively, which were significantly higher than those of the first tubal pregnancy (4.3,5.7 P, 0.038 and 0.017, respectively).3.Ureaplasma Urealyticum infection was sensitive to doxycycline, josamycin and clarithromycin, and had higher resistance to ofloxacin and roxithromycin.The percentage of pelvic adhesions in 4.CT and UU positive tubal pregnancy was 80.8% and 76.4% respectively, and 84.4% and 80.7% in patients with pathological changes of salpingitis and abnormal appearance of fallopian tubes in the study group, respectively.Compared with the control group, the X _ 2 value of the control group was 112 and 95 (P = 0.000), respectively.5.The recanalization of fallopian tube in 25 cases of tubal pregnancy infected by CT and UU at 3 months after operation. The recanalization rate of fallopian tube was 77.8% and 14% / 18% respectively. The rate of recanalization of CT infection was 57.1%. There was no significant difference between the two groups.Conclusion:1.Sexually transmitted diseases were associated with tubal pregnancy, the main pathogens were Chlamydia trachomatis (CTL) and Ureaplasma Urealyticum (UUU), and there were few cases of gonococcal infection.2.The oviduct of tubal pregnancy showed chronic inflammatory changes, and the tubal of most of the patients could be restored to patency after 3 months of follow up after regular treatment.3.The detection of sexually transmitted diseases (STDs) as a routine test for ectopic pregnancy helps to determine the type of pathogens.
【学位授予单位】：暨南大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R759

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