国际生殖健康/计划生育杂志

国际生殖健康/计划生育 ›› 2012, Vol. 31 ›› Issue (4): 281-283.

• 论著 • 上一篇    下一篇

不孕症患者术前阴道微生态状况与盆腹腔病变的关系

陈 晓 ,陈亚琼,侯海燕   

  1. 中国人民武装警察部队后勤医学院附属医院妇产科
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2012-07-15 发布日期:2012-07-15
  • 通讯作者: 陈亚琼

Analysis of the Association Between Preoperation Vaginal Ecology and Pelvic Celiac Disease in Sterilized Women

CHEN Xiao，CHEN Ya-qiong，HOU Hai-yan   

  1. Department of Obstetrics and Gynecology，the Affiliated Hospital of the Chinese People's Armed Forces Logistic College，Tianjin 300162，China
  • Received:1900-01-01 Revised:1900-01-01 Published:2012-07-15 Online:2012-07-15
  • Contact: CHEN Ya-qiong

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摘要： 目的：分析不孕症患者阴道分泌物中病原体和阴道微生态状况及相关因素。方法：选择2008年1月—2009年12月因不孕症接受宫腹腔镜检查和治疗的患者850例，术前常规进行病史采集并取阴道分泌物，利用Nugent评分评价阴道菌群后，分为菌群正常组（307例，占36.12%）和菌群异常组（543例，占63.88%）。根据菌群异常情况，又将菌群异常组分为5组，分别为乳杆菌减少组（325例）、革兰阳性小杆菌为优势菌组（173例）、细菌性阴道病（BV）组（26例）、菌群抑制组（11例）和外阴阴道假丝酵母菌病（VVC）组（8例），并进行回顾性分析。结果：阴道菌群异常组患者中痛经史者的检出率高于菌群正常组（P＜0.05），OR值及95%CI为1.38（1.02～1.88）。菌群异常组盆腔子宫内膜异位症的检出率高于菌群正常组（OR=1.82，95%CI为1.09～3.04，P=0.021）。BV阳性组输卵管扭曲的发生率相对较高（OR=5.02，95%CI为2.11~11.94，P=0.000）。结论：积极治疗子宫内膜异位症对于保护阴道正常微环境有重要的临床意义。恢复正常阴道微生态环境，对保护患者生育功能有一定作用。

关键词: 阴道, 不育, 女（雌）性, 子宫内膜异位症, 外阴阴道, 阴道病, 细菌性

Abstract: Objective： To analyze the vaginal secretion pathogen and ecology correlative factors in infertile patients. Methods：We did the retrospective survey included 850 infertile women who accepted the hysteroscopy and laparoscopy examination from Jan 2008 to Dec 2009. Vaginal secretion was collected before operation. The Nugent grade was used to evaluate the vaginal bacteria. The patients were then divided into two groups，normal bacteria group （307 cases，36.12%） and abnormal group （543 cases，63.88%）. The abnormal group was further divided into five subgoups as follows, lactobacillus decreased group （325 cases），Gram positive bacillus small group （173 cases），bacterial vaginal disease group （26 cases），flora inhibit group （11 cases） and vulvovaginal candidiasis group （8 cases）. Results：The dysmenorrheal rate of abnormal bacteria group was higher than that of normal bacteria group （P＜0.05），OR （95%CI ） was 1.38 （1.02-1.88），while the incidence rate of pelvic endometriosis was higher than that of normal bacteria group （OR=1.82，95%CI：1.09~3.04，P=0.021）. The tubal distortion rate of the BV positive group was higher than that of normal group （OR=5.02，95%CI：2.11~11.94，P=0.000）. Conclusions：It is important to treat actively endometriosis for protecting the vaginal microenvironment. It would play some roles in the fertility protection to reconstruct the normal vaginal ecology.

Key words: Vagina, Infertility, female, Endometriosis, Vulvovaginal, Vaginosis, bacterial