妊娠期需氧菌性阴道炎的诊断与治疗  

Diagnosis and treatment of aerobic vaginitis during pregnancy

作　　者：韩姹[1] 薛凤霞[1] HAN Cha;XUE Feng-xia(Tianjin Medical University General Hospital,Tianjin Key Laboratory of Female Reproductive Health and Eugenics,Tianjin 300052,China)

机构地区：[1]天津医科大学总医院妇产科天津市女性生殖健康与优生重点实验室,天津300052

出　　处：《中国实用妇科与产科杂志》2021年第10期994-998,共5页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：国家自然科学基金(81471419,82071674);天津市重大疾病防治科技重大专项(18ZXDBSY00200)。

摘　　要：需氧菌性阴道炎(aerobic vaginitis,AV)是由于阴道内乳杆菌水平下降,需氧菌过度繁殖导致的阴道炎症。妊娠期AV常见致病菌为B族链球菌、大肠埃希菌、粪肠球菌和金黄色葡萄球菌,可引起早产、胎膜早破、绒毛膜羊膜炎、新生儿感染等不良母儿结局。有症状及无症状但既往有感染相关流产或者早产病史的高风险妊娠女性需进行AV筛查。妊娠期AV可依据临床特征结合湿片镜下AV评分法或革兰染色涂片结合临床特征的联合诊断标准进行诊断。妊娠期AV应在权衡治疗获益与潜在风险的情况下进行治疗,可采用妊娠期安全的抗菌药物,也可选用乳杆菌制剂和中成药等辅助治疗。Aerobic vaginitis(AV)is a type of vaginitis characterized by decreased Lactobacillus species and overgrowth of aerobes.The common bacteria related to AV during pregnancy included Group B streptococci,Escherichia coli,Enterococcus faecalis and Staphylococcus aureus,which may cause preterm delivery,premature rupture of membranes,neonatal infection and other adverse maternal and fetal outcomes.High-risk pregnant women who have a history of infection-related miscarriage or preterm birth,with symptoms or not,should receive AV screening.AV during pregnancy can be diagnosed according to scores based on wetmount smears with consideration of clinical features,or gram stain combined with clinical features.Weighing the benefits and potential risks of treatment should be taken into consideration for AV pregnant women.Safe antibiotics for pregnancy should be considered during treatment.Live Lactobacillus-containing supplementary agents and Chinese traditional medicine can also be used.

关 键 词：妊娠 需氧菌性阴道炎 筛查 

分 类 号：R711.31[医药卫生—妇产科学]