细菌性阴道病合并妇科感染性疾病的临床分析  

Clinical analysis of bacterial vaginosis complicated with gynecological infectious diseases

作　　者：霍大志[1] 贺建民[1] 陈益明[1] 

机构地区：[1]杭州市余杭区妇幼保健院医务科,浙江杭州311100

出　　处：《中华医院感染学杂志》2014年第6期1521-1522,1525,共3页Chinese Journal of Nosocomiology

基　　金：浙江省医药卫生科技基金项目(2012KYB173)

摘　　要：目的分析细菌性阴道病合并妇科感染性疾病的临床特点,指导临床采取相应的抗感染措施。方法选取2010年1月-2012年1月确诊细菌性阴道病患者238例为研究对象,对其询问病史、行常规白带检查、阴道镜检查,并留取阴道或宫颈分泌物进行病原体培养,观察组细菌培养结果及混合感染,同时观察患者合并妇科感染性疾病,对患者采用甲硝唑口服及维生素C阴道内治疗或敏感抗菌药物治疗,观察治疗效果,采用SPSS19.0软件对所用数据进行统计分析。结果 238例细菌性阴道病患者病原体培养出解脲脲支原体(Uu)占28.57%、棒杆菌属占23.53%、表皮葡萄球菌占18.91%;178例合并其他感染占74.79%,单纯性感染细菌阴道病60例,占25.21%,其中,混合型感染以细菌+酵母菌属最多见占23.53%,细菌+滴虫感染占16.81%、细菌+支原体属感染占14.71%、细菌+衣原体属感染占12.61%;178例混合型感染患者中44.94%合并轻重不等的盆腔炎,15.73%合并附件炎,6.74%合并子宫内膜或宫体炎,3.37%合并慢性盆腔结缔组织炎,1.12%合并盆腔炎性包块;采用甲硝唑和维生素C或其他敏感抗菌药物治疗后,88.24%的患者治愈,11.76%的患者好转。结论细菌性阴道病较大部分为混合感染,患者可合并多种妇科感染性疾病,临床宜做到早期诊断、早期治疗,治疗可首选甲硝唑、维生素C。OBJECTIVE To analyze the clinical characteristics of bacterial vaginosis complicated with gynecological infectious diseases so as to put forward corresponding measures for control of infections. METHODS A total of 238 patients with confirmed bacterial vaginosis, who were treated in the hospital from Jan 2010 to Jan 2012, were recruited as the study objects, then the medical history was inquired, the routine vaginal examination and colposcopy were performed, the vaginal or cervical secretions were sampled for culture of pathogens, the result of the bacterial culture was observed, the incidence of mixed infections was analyzed, meanwhile, the patients complicated with gynecological infectious diseases were observed, the patients were treated with oral administration of metronidazole and vitamin C, vaginal treatment or sensitive antibiotics, the therapeutic effect was observed, and the statistical analysis of all the data was performed with the use of SPSS19.0 software. RESULTS Of totally the pathogens isolated from the 238 patients with bacterial vaginosis, the Ureaplasma urealyticum （Uu） accounted for 28.57%, Corynebacterium 23.53%, Staphylococcus epidermidis 18.91%. Totally 178 cases of mixed infections accounted for 74.79 %, and 60 cases of simple infectious bacterial vaginosis accounted for 25.21%, among which the cases of mixed infections caused by bacteria plus yeast accounted for 23.53%, the cases of mixed infections caused by bacteria plus trichomonas 16.81%, the cases of mixed infections caused by bacteria plus Mycoplasrna 14.71%, the cases of mixed infections caused by bacteria plus Chlamydia 12.61%. Of the 178 cases of mixed infections, 44.94% were complicated with varying severities of pelvic inflammatory disease, 15.73 % complicated with annex inflammation, 6.74% complicated with endometrial or inflammation palace, 3.37% complicated with chronic pelvic connective tissue inflammation, 1. 12% complicated with a pelvic mass; 88.24% of the patients were cured and 11. 76% were improved after the treatme

关 键 词：细菌性阴道病 妇科感染 甲硝唑 

分 类 号：R711.73[医药卫生—妇产科学]