应用阴道微生态检测诊断人工流产术前女性阴道炎的价值初探  

The value of microecological assessment of vaginal microflora in diagnosis of vaginitis of the women before the induced abortion

作　　者：王威[1] 耿力[1] 武淑英[1] 王晓晔[1] 王迎[1] 

机构地区：[1]北京大学第三医院妇产科,100191

出　　处：《中国计划生育学杂志》2013年第3期181-184,共4页Chinese Journal of Family Planning

摘　　要：目的:探讨应用阴道微生态检测手段对人工流产术前妇女阴道炎的诊断价值,并了解阴道炎分泌物菌群分布。方法:选取2012年3月1日～5月31日在北京大学第三医院计划生育门诊欲行人工流产妇女中患阴道炎患者,进行阴道分泌物阴道微生态检测。结果:407例患者以细菌性阴道病和外阴阴道假丝酵母菌病为主,应用阴道微生态检测进行Nugent评分(≥7分)诊断为细菌性阴道病123例(30.2%),外阴阴道假丝酵母菌病92例(22.6%),此外还有164例(40.3%)患者没有特异病原体的感染,仅表现为菌群失调或清洁度异常。407例患者中菌群正常占26.5%,菌群密集度++～+++占70.8%,菌群多样性++～+++占65%,pH>4.5占31.7%。患阴道炎妇女中普遍存在异常菌群,主要包括:革兰阳性小杆菌(29.5%)、革兰阴性小杆菌(18.2%)、革兰阳性球菌(12.5%)、革兰阴性球菌(11.8%)。结论:阴道微生态评价体系是对人工流产术前女性阴道炎进行确切临床诊断的一个重要检测手段,能明确指导临床诊断阴道感染,并可能为围手术期的合理治疗提供依据。Objective ： To investigate the importance of microecological evaluation in diagnosing vaginitis before the induced abortion, and to investigate the distribution of vaginal micmflora in the women with vaginitis before the induced abortion. Methods ： A total of 407 women with diagnosed vaginitis who requested for an induced abortion were recruited from Mar 1, 2012 to May 31,2012, and the samples of vaginal secretion were collected for the microecological evaluation of vaginal microflora.Results： The bacterial vaginosis （BV） and vulvovaginal candidiasis （VVC） were the main diseases in the 407 patients, with 30.2% （123/407） of BV diagnosed by Nugent score of ≥7, and 22.6% （92/407） of VVC. There were 164 women who had no specific infectious agents and were characterized by only abnormal vaginal microflora. Of the 407 women, 26.5% showed normal vaginal microflora, 70.8% were with the microflora density of degree ＋ ＋ ～ ＋ ＋ ＋, 65% with the microflora diversity of degree ＋ ＋ ～ ＋ ＋ ＋, and 31.7% with the vaginal secretion of pH 〉4.5. The abnormal vaginal microflora mainly included gram - positive dialister bacterium （29.5%）, gram - negative microbacterium （ 18.2% ）, gram - positive coccus （12.5%） and gram- negative coccus （11.8%）. Conclusion： The microecological evaluation of vaginal microflora provides an important method to exactly diagnose women＇s vaginitis before the induced abortion, and may instruct the perioperative treatment.

关 键 词：阴道微生态 人工流产 阴道菌群 阴道炎 

分 类 号：R711.3[医药卫生—妇产科学]