阴道镜操作对阴道微生态的影响  

Effects of colposcopy procedure on vaginal microecology

作　　者：徐子杰 张岱[1] XU Zi-jie;ZHANG Dai(Department of Obstetrics and Gynecology,Peking University First Hospital,Beijing 100034,China;不详)

机构地区：[1]北京大学第一医院妇产科,北京100034 [2]北京市朝阳区妇幼保健院

出　　处：《中国微生态学杂志》2022年第5期590-594,598,共6页Chinese Journal of Microecology

摘　　要：目的初步探讨阴道镜操作对于阴道微生态的影响。方法选取北京大学第一医院2019年3月至2019年6月行阴道镜检查的患者,共60例,在阴道镜检查前及阴道镜检查结束2~3周行阴道微生态检测,分析患者阴道镜检查前后阴道微生态变化情况。结果60例患者阴道镜检查前后均无症状。阴道镜检查前菌群异常者16例,包括细菌性阴道病(BV)13例,发生率为21.6%;外阴阴道假丝酵母菌病(VVC)1例,发生率为0.16%;微生态异常比26.6%。60例患者阴道镜检查前后阴道微生态变化、菌群密集度、多样性、优势菌、真菌检出率差异无统计学意义(均P<0.05)。阴道分泌物pH值在阴道镜检查前后的中位数值均为4.1。检查后,16例检查前阴道微生态异常的患者中8例改善,7例无变化,1例由菌群异常转变为菌群抑制。阴道镜检查前后阴道微生态无变化者44例(73.3%),微生态好转8例(13.3%),均发生于BV和菌群异常的患者;阴道微生态由正常转为异常7例(11.7%)。检查前后阴道微生态均异常但发生变化者1例。结论阴道镜检查者菌群异常比例较高,阴道镜检查后小部分患者有可能新发阴道微生态异常,建议阴道镜检查前后及时进行阴道微生态检测。Objective To explore the effect of colposcopy procedure on vaginal microecology.Methods A prospective study was carried out on 60 patients who underwent colposcopy from March 2019 to June 2019 in our hospital.The microecology of vagina was examined immediately before colposcopy and 2 to 3 weeks after colposcopy.The changes of vaginal microecology before and after colposcopy were analyzed.Results There were no symptoms before and after colposcopy in the 60 cases.Sixteen cases had abnormal flora before colposcopy.Among them,there were 13 cases of bacterial vaginosis(BV),1 case of vulvovaginal candidiasis(VVC),and 26.6%of microecological abnormalities.There were no significant differences in the density,diversity,dominant bacteria and fungal detection rate after colposcopy.The median value of pH of vaginal secretion before and after colposcopy was 4.1.Among the 16 patients with pre examination microecological abnormality,8 improved,7 remained unchanged,and 1 changed from bacterial abnormality to bacterial inhibition after colposcopy.Before and after colposcopy,there was no change in vaginal microecology in 44 cases(73.3%);8 cases(13.3%)of improvement in vaginal microecology occurred in patients with BV and abnormal flora;7 cases(11.7%)of deterioration in vaginal microecology occurred in patients with normal flora.One case was abnormal before and after vaginal microecology.Conclusion The proportion of abnormal flora in the population examined by colposcopy is high,and a small number of patients may have new vaginal microecological abnormalities after colposcopy.It is suggested that examination should be carried out in time before and after colposcopy.

关 键 词：阴道微生态 阴道镜 宫颈病变 宫颈细胞学 宫颈人乳头瘤病毒感染态 

分 类 号：R446.5[医药卫生—诊断学]