催引产时多次阴道检查对阴道微生态的影响  

Effect of multiple vaginal examinations on vaginal microecology during induced labor

作　　者：罗霞 陈真[2] LUO Xia;CHEN Zhen(Department of Obstetrics,Xuanhan People's Hospital,Dazhou 636150,China;Department of Obstetrics,Chongqing Health Center for Women and Children,Chongqing 400013,China)

机构地区：[1]四川省宣汉县人民医院产科,达州636150 [2]重庆市妇幼保健院产科,重庆400013

出　　处：《中国真菌学杂志》2020年第4期202-205,共4页Chinese Journal of Mycology

基　　金：重庆市卫健委面上项目(201935039)。

摘　　要：目的观察催引产时多次阴道检查对阴道微生态的影响。方法随机选取本院2017年6月~2018年6月收治的产妇150例作为样本,调查足月产(健康无症状单胎妊娠)催引产时的阴道检查次数,将其分为A组(检查<2次)、B组(3~6次)、C组(>6次)三组,取阴道分泌物进行pH检查、H 2O 2含量检测及细菌培养,经过革兰染色后在油镜下观察,后行阴道微生态(阴道菌群的密集度、多样性、优势菌、炎性反应状况等),对比三组的阴道微生态检查结果。结果A组白念珠菌检出率8%(4/50)、大肠埃希菌6%(3/50)、阴道加德纳菌检出率0(0/50)、大肠杆菌检出率0(0/50)、乳酸杆菌检出率4%(2/50)、表皮葡萄球菌检出率0(0/50)、细菌性阴道炎发生率4%(2/50)、微生态失调率4%(2/50)、阴道pH值(4.01±0.11)、软产道损伤率10%(5/50)、胎膜早破率0(0/50)、新生儿感染率4%(2/50)。发生胎膜早破者,微生态失调者占0(0/0)。B组白念珠菌检出率16%(8/50)、大肠埃希菌14%(7/50)、阴道加德纳菌检出率10%(5/50)、大肠杆菌检出率4%(2/50)、乳酸杆菌检出率2%(1/50)、表皮葡萄球菌检出率0(0/50)、细菌性阴道炎发生率20%(10/50)、微生态失调率28%(14/50)、阴道pH值(4.08±0.22)、软产道损伤率26%(13/50)、胎膜早破率4%(2/50)、新生儿感染率6%(3/50)。发生胎膜早破者,微生态失调者占100%(2/2)。C组白念珠菌检出率60%(30/50)、大肠埃希菌46%(23/50)、阴道加德纳菌检出率46%(23/50)、大肠杆菌检出率8%(4/50)、乳酸杆菌检出率0(0/50)、表皮葡萄球菌检出率2%(1/50)、细菌性阴道炎发生率80%(40/50)、微生态失调率80%(40/50)、阴道pH值(4.80±0.14)、软产道损伤率50%(25/50)、胎膜早破率10%(5/50)、新生儿感染率12%(6/50)。发生胎膜早破者,微生态失调者占100%(5/5)。结论催引产时多次阴道检查,可导致阴道微生态失调,其中白念珠菌感染率居首位,其次是大肠埃希菌、阴道加德纳菌。阴道微生态失调还�Objective To observe the effect of multiple vaginal examinations on vaginal microecology during induced labor.Methods 150 cases of parturients admitted to our hospital from June 2017 to June 2018 were randomly selected as samples to investigate the frequency of vaginal examination during induction of labor in full-term(healthy asymptomatic single pregnancy).They were divided into three groups:group A(examination<2 times),group B(3-6 times),group C(more than 6 times).Vaginal secretions were taken for pH examination and the content of hydrogen peroxide.Detection and bacterial culture,observation under oil microscope after gram staining,vaginal microecology(vaginal flora density,diversity,dominant bacteria,inflammatory reaction status,etc.)were performed to compare the results of three groups of vaginal microecology examination.Results In group A,8%(4/50)of Candida albicans,6%(3/50)of Escherichia coli,0(0/50)of Gardnerella vaginalis,0(0/50)of E.coli,4%(2/50)of Lactobacillus,0(0/50)of Staphylococcus epidermidis,4%(2/50)of bacterial vaginitis,4%(2/50)of microecological disorder,4.01±0.11 of vaginal pH value and 10%of soft birth canal injury rate in group A (5/50), premature rupture of membranes rate was 0 (0/50), neonatal infection rate was 4% (2/50). In the cases of premature rupture of membranes, 0 (0/0) had micro ecological imbalance. In group B, the detection rate of Candida albicans was 16% (8/50), Escherichia coli was 14% (7/50), Gardnerella vaginalis was 10% (5/50), E.coli was 4% (2/50), Lactobacillus was 2% (1/50), Staphylococcus epidermidis was 0 (0/50), bacterial vaginitis rate was 20% (10/50), microecological imbalance rate was 28% (14/50), vaginal pH value (4.08±0.22), soft birth canal damage The injury rate was 26% (13/50), premature rupture of membranes rate was 4% (2/50), neonatal infection rate was 6% (3/50). In the cases of premature rupture of membranes, 100% (2/2) of the patients had microecological disorders. In group C, the detection rate of Candida albicans was 60% (30/50), Escherichia coli was

关 键 词：催引产时阴道检查 阴道微生态 妊娠结局 

分 类 号：R519.3[医药卫生—内科学]