孕中期乳杆菌干预与早产结局的相关分析

Correlation analysis of using lactobacillus at the second trimester associated with premature birth outcome

目的探讨妊娠中期应用乳杆菌活菌胶囊对早产及先兆早产的预防价值。方法选择石家庄市第四医院2013年门诊产检的妊娠中期的孕妇,筛查出阴道微生态失调1 032例。根据是否接受乳杆菌活菌胶囊治疗分为观察组427例与对照组605例。观察组孕妇睡前温开水冲洗外阴后于阴道后穹窿处放置乳杆菌活菌胶囊1粒,连用10d。10d后行阴道微生态检查,仍异常者再治疗10d。对照组孕妇未进行用药干预治疗。观察并评估观察组孕妇治疗后阴道内乳杆菌阳性率及阴道分泌物清洁度的变化,比较两组孕妇发生早产或先兆早产的情况。结果观察组孕妇治疗后阴道pH(4.04±0.12)较前(4.83±0.09)明显下降(P<0.05);乳杆菌阳性率(81.73%)较前(0.00%)明显上升(P<0.05)。观察组孕妇先兆早产发生率为5.39%,显著低于对照组的8.93%(χ2=4.985,P<0.05);观察组孕妇早产发生率为0.70%,显著低于对照组的2.98%,差异有统计学意义(χ2=5.782,P<0.05)。结论妊娠晚期孕妇阴道微生态失调与先兆早产及早产的发生关系密切,乳杆菌活菌胶囊可恢复正常的阴道微生态环境,降低先兆早产及早产的发生率,对预防先兆早产及早产的风险有一定临床价值。

Objective To investigate the application trimester vaginal lactobacillus capsules and the prevention value of premature and preterm labor.Methods 1,032 cases of the second trimester pregnant women from2013 in the Fouth Hospital of Shijiazhuang were selected and divided into observation group and control group by random？allocation.427cases（observation group）were assigned to receive Living Preparation of Lactobacillus for 10 days,then another 10 days if the vaginal microflora still abnormal and another 605cases（control group）to did not give any interference.Observed and assessed the changes of the vagina,lactic acid bacteria and vaginal secretions cleanliness,compared the occurrence rate of preterm or threatened preterm labor of the two groups.Results The vaginal pH（4.04±0.12）was significantly decreased after treatment than before（4.83±0.09）（P〈0.05）;the positive rate of lactobacillus（81.73%）was significantly increased compared with the previous（0.00%）（P〈0.05）.The rate of threatened premature labor was5.39%in observation group,significantly lower than the control group 8.93%（χ^2=4.985,P〈0.05）.The incidence of premature birth was 0.70%in observation group,significantly less than 2.98% of the control group,the difference was statistically significant（χ^2=5.782,P〈0.05）.Conclusion The imbalance vaginal microflora threatened preterm labor and preterm birth are closely related,lactobacillus vaginal capsules restore normal vaginal micro-ecological environment,reduce the incidence of threatened premature labor and preterm delivery.It has a certain clinical value for prevention of threatened premature labor and premature birth.