不同妊娠期外阴阴道感染假丝酵母菌感染分析及其对妊娠结局影响的临床研究

Vaginal candida infections at different pregnancy stage and its effect on pregnancy outcomes

目的:探讨不同妊娠期外阴阴道感染假丝酵母菌感染情况及对妊娠结局的影响。方法:选取2011年4月至2013年1月产前检查患者为研究对象,均进行外阴阴道假丝酵母菌病涂片、培养等,对其中145例假丝酵母菌作为观察组,另外选取同时期无感染的307例作为对照组,观察在妊娠结局等方面差异。结果:452例妊娠者,假丝酵母菌培养阳性率为32.08%,假丝酵母菌感染有症状患者为36例,占24.83%,发病率为7.96%。早中晚孕期有症状的外阴阴道假丝酵母菌病(VVC)的31.54%、33.12%、31.55%,其差异无统计学意义(P>0.05);妊娠期有症状组患者产褥感染、胎盘早破、伤口愈合不良、早产等发生率与对照组及无症状组比较明显升高,差异显著,有统计学意义(P<0.05)。外阴阴道假丝酵母菌感染有症状组新生儿鹅口疮、巨细胞毒感染、尿布皮炎感染率明显高于无症状组,差异有统计学意义(均P<0.05)。结论:孕期与妊娠期妇女假丝酵母菌的感染率无相关性,妊娠期VVC增高孕妇阴道裂伤、伤口愈合不良、胎膜早破、产褥感染等风险,同时对新生儿产生一定的影响,导致新生儿早产和感染的增加。

Objectives： To investigate vaginal candida infections at different gestation period and its effect on pregnancy outcomes. Methods： Pregnant women received antenatal examination from April 2011 to January 2013 were included and conducted vulvovaginal candidiasis smear,culture and etc. Of them,the 145 candida infected ones were selected as observation group and 307 non- infected ones as control group. Difference in pregnancy outcome was compared. Results： In the 452 cases of pregnancy,the candida culture positive rate was 32. 08%,and36 cases had candida infection symptom accounting for 24. 83%,an incidence rate of 7. 96%. Difference in symptomatic vulvovaginal candidiasis（ VVC） proportion at early,middle and late pregnancy stage（ 31. 54%,33. 12%,31. 55%） was not statistically significant（ P 〉0. 05）. The incidence of puerperal infection,premature rupture of the placenta,poor wound healing and premature delivery of symptomatic group was significantly higher than the control group,with statistically significant difference（ P〈 0. 05）. The infection rate of mycotic stomatitis,cytomegalovirus viral infections and diaper dermatitis infection in symptomatic group was significantly higher than the control group,with statistically significant difference（ P〈 0. 05）. Conclusion： Candida infection rate is not related to pregnancy stage,and VVC during pregnancy increases the risks of maternal vaginal laceration,wound healing,premature rupture of membranes and puerperal infection,hereby increasing the incidence of premature birth and neonatal infection.