腹腔镜腹膜阴道成形术术后人工阴道微生态分析  

Analysis on the vaginal microecology of patients after laparoscopic peritoneal vaginoplasty

作　　者：秦成路[1] 罗光楠[1] 余鸿标[1] 唐杰[1] 杜敏[1] 潘宏信[1] 

机构地区：[1]深圳大学附属罗湖医院妇科微创治疗中心,广东深圳518001

出　　处：《中国微生态学杂志》2015年第11期1342-1345,共4页Chinese Journal of Microecology

摘　　要：目的了解腹腔镜腹膜阴道成形术后患者人工阴道的微生态状况,探讨腹腔镜腹膜阴道成形术后阴道微生态评价的临床意义。方法选取54例性腹腔镜腹膜阴道成形术术后回访的患者,取阴道分泌物进行微生态评价,同时检查患者的人工阴道物理功能及阴道壁组织活检。结果腹腔镜腹膜阴道成形术术后患者的人工阴道具有正常阴道的组织学特点,物理功能良好。54例患者中阴道菌群密集度为Ⅱ-Ⅲ级者48例,占88.9%;菌群多样性为Ⅱ-Ⅲ级者39例,占72.2%;优势菌为革兰阳性大杆菌者15例,占27.8%;pH≤4.5者31例,占57.4%。无病原菌感染。术后时间≥2年的23例患者阴道微生态正常者占14例（60.9%）,异常者占9例（39.1%）。术后时间〈2年的31例患者中阴道微生态正常者11例（35.5%）,异常者20例（64.5%）。菌群异常主要包括：菌群抑制（包括未见到任何细菌）、革兰阳性短杆菌（12.3%）、革兰阳性球菌（31.5%）、革兰阴性短杆菌（9.6%）。结论 （1）先天性无阴道的患者在阴道成形术后不同程度存在菌群失调表现。表现为pH值升高,阴道内菌群多样性欠佳,正常优势菌群存在比例低。（2）手术后时间是影响腹膜阴道成形术后阴道微生态的重要因素,随着术后时间的延长,人工阴道阴道微生态正常的比例逐渐增加。（3）评价腹腔镜腹膜阴道成形术后阴道微生态环境的状况,对预防与治疗术后人工阴道感染、促进人工阴道的健康发展具有重要意义。Objective To investigate the microecological status in vagina of patients after operation of laparoscopic peritoneal vaginoplasty,and evaluate the clinical significance of vaginal microecological evaluation to patients with with artificial vagina.Methods 54 patients who received the operation of laparoscopic pertoneal vaginoplasty were evaluated for their vaginal microecosystem.Results 48（88.9%）patients had levelⅡ orⅢ of vaginal flora density;39（77.2%）patients had levelⅡ orⅢ of flora diversity.Lactobacilli were found predominant in 15（27.8%）patients;31cases were pH≤4.5,accounting for 57.4%.The positive rates of VVC and Trichomonas were zero.Dysbiosis cases accounted for 53.7%（64.5%in less than 2years after the operation,and 39.1% after two years and above）.Conclusion（1）Vaginal microecological imbalance are common in patients after accepting laparoscopic peritoneal vaginoplasty;（2）The rate of vaginal microecological imbalance reduces along with the time after operation;（3）Evaluation of vaginal microenvironment after laparoscopic peritoneal vaginoplasty is of important significance for the prevention of reproductive tract infection and neovagina health.

关 键 词：腹腔镜腹膜阴道成形术 术后 阴道微生态 阴道菌群 

分 类 号：R713.31[医药卫生—妇产科学]