93例女童外阴炎病因分析

Analysis of Symptoms and Pathogens in 93 Prepubertal Girls with Vulvitis

目的探讨女童外阴炎临床表现与病因的关系。方法观察患有外阴炎女童的临床表现,取外阴分泌物检查炎性细胞、线索细胞、念珠菌、蛲虫卵、淋球菌(Ng)、沙眼衣原体(Ct)、解脲脲原体(Uu)。取皮损渗出液和静脉血分别检查梅毒螺旋体和RPR。结果女童外阴炎的主要症状有外阴分泌物增多,或脓性,有异味,外阴瘙痒、尿疼、尿频。临床体征有外阴黏膜充血,外阴或肛周皮肤发红或红斑。病原学检查阳性结果分别是G-或G+细菌14例,念珠菌8例,蛲虫卵9例,Ng5例,Ct4例,Uu22例,RPR3例,梅毒螺旋体1例。结论临床表现和病原学结果显示引起女童外阴炎的病因主要有G-或G+细菌、念珠菌、蛲虫。女童生殖道结构特点可能是其易受外界病原菌感染的主要原因。患有性病病原性外阴炎的女童,虽无性疟待史,但其父亲或母亲多有性病史,提示家庭密切接触或不良的环境卫生和个人卫生习惯可致女童性病性外阴炎。值得注意的是:除淋菌和梅毒感染者的临床症状具有特征性,其他几种病原菌所致的女童外阴炎,其临床表现特异性较差,尤其是蛲虫所致的外阴炎常被误诊为性病性外阴炎。

Objective To study the relation ship between symptoms and pathogens of vulvitis in prepubertal girls. Methods The symptoms of patients were observed and inflammation cells, clue cells, Candida, pinworm ovum, N.gonorrhea(Ng), U. urealyticum(Uu), C. tracholitic(Ct) in the vulval secretion were detected. The plasma from lesion for P. pallidum was examined and rapid plasma reagin(RPR) was tested with blood serum. Results The symptoms of the vulvitis of 93 prepubertal girls involved increase of discharge or purulent, abnormal smell, vaginal itching, dysuria, frequent micturition. The primary signs are vaginal mernbrance congestion, skin redness or erythema of vulva. The positive results of pathogens examination are 14 gram-negative or gram-positive bacteria, 8 Candida, 9 pinworm ovum, 5 Ng, 5 Ct, 22 Uu, 3 RPR and 1 P. pallidum respectively. Conclusion The results suggest that the pathogens of the vulvitis in prepubertal girls are mainly gram-negative or gram-positive bicteria, Candida and pinworm. Perhaps the anatomy of prepubertal girl associated with microorganisms infection. Although the prepubertal girls with vulvitis have no experience of being abused, their parents have history of STD. And it shows that close family contact, poor sanitation and bad presonal habit are responsible for the vulvitis in prebertal girls. It is noteworthy that the symptoms of vulvitis in prepubertal girls has no specific characteristics except infected by N.gonorrhea and P.pallidum. Especially pinworm vulvitis were often misdiagnosed as generative vulvitis.