盆腔脓肿与非感染性良性附件包块宫颈分泌物病原体培养的对比研究

Culture of pathogens from cervical secretions of patients with pelvic abscess and non-infectious benign adnexa mass:a comparative study

目的探讨外源性病原菌在盆腔脓肿中的致病作用,为临床治疗盆腔脓肿提供参考。方法选取2014年1月-2016年6月盆腔脓肿住院患者105例为研究组,并选取同期住院的非感染性良性附件包块患者107例为对照组;回顾性分析两组患者的病历资料,采集两组患者的宫颈分泌物,分别检测沙眼衣原体、人型支原体和解脲支原体;并做淋病奈瑟菌培养;根据B超结果记录两组病例盆腔包块直径。结果研究组与对照组在避孕套使用方面差异有统计学意义(14.29%vs 41.12%,P<0.01),在宫内节育器放置方面差异有统计学意义(37.14%vs 9.35%,P<0.01);两组沙眼衣原体和人型支原体阳性率比较,分别为22.34%vs 5.61%和31.52%vs 9.80%,差异有统计学意义(P<0.01);解脲脲原体在两组中的感染率均最高(54.35%vs 55.88%),但两组间差异无统计学意义;淋球菌感染率较低(2.56%vs 0.00%),两组比较差异无统计学意义。结论使用安全套能降低盆腔炎性疾病的患病率,而使用宫内节育器的妇女更容易感染盆腔炎性疾病;沙眼衣原体是盆腔脓肿的主要致病菌;人型支原体阳性率高于对照组的结果表明人型支原体也可能是盆腔炎性疾病的致病菌之一;两组中的解脲脲原体均呈现高阳性率;由于解脲脲原体既是致病菌也是共生菌,单纯的解脲脲原体阳性并不具有明确的临床意义。

OBJECTIVE To explore the pathogenic effect of exogenous pathogens on pelvic abscess so as to provide guidance for clinical treatment of pelvic abscess.METHODS Totally 105 patients with pelvic abscess who were hospitalized from Jan 2014 to Jun 2016 were chosen as the study group,and 107 patients with non-infectious benign adnexa mass who were hospitalized during the same period were set as the control group.The medical records of the two groups of patients were retrospectively analyzed,the cervical secretions were collected from the two groups of patients so as to detect Chlamydia trachomatis,Mycoplasma hominis,and Ureaplasma urealyticum;the culture of Neisseria gonorrhoeae was carried out,and the diameters of pelvic masses of the two groups of patients were recorded according to the result of B ultrasound.RESULTS There was significant difference in the use of condom between the study group and the control group （14.29% vs 41.12%,P〈0.01）;there was significant difference in the placement of intrauterine device （37.14 % vs 9.35 %,P〈0.01）.The positive rate of C.trachomatis of the study group was 22.34%,higher than 5.61% of the control group;the positive rate of M.hominis of the study group was 31.52%,higher than 9.80% of the control group,and there was significant difference between the two groups （P〈0.01）.The incidence rate of U.urealyticum infection was 54.35% in the study group,55.88% in the control group,and there was no significant difference between the two groups.The incidence rate of N.gonorrhoeae infection was 2.56% in the study group,0.00% in the control group,and there was no significant difference between the two groups.CONCLUSION The use of condom may reduce the prevalence rate of pelvic inflammatory diseases,however,the women who use the intrauterine device are more likely to have the pelvic inflammatory diseases.C.trachomatis is the major species of pathogen causing the pelvic abscess.The positive rate of M.hominis of the study group is higher than that of the control group,which indicates that the M.hominis may also be one of the species of pathogens causing the pelvic inflammatory diseases.The positive rate of U.urealyticum is high in both groups;since the U.urealyticum is both pathogenic bacteria and symbiotic bacteria,it does not show such significant clinical significance that the U.urealyticum is simply detected positive.