腹腔镜下全子宫切除术对阴道微生物菌落的影响及乳酸杆菌干预的作用分析

Effect of laparoscopic hysterectomy on vaginal microflora and the effect of lactobacillus intervention

目的分析腹腔镜下全子宫切除术对阴道微生物菌落的影响及乳酸杆菌干预作用。方法以2014年5月至2016年12月武汉科技大学医院实施腹腔镜全子宫切除术的女性患者80例为研究对象,并随机分为观察组、对照组各40例,观察组术后3个月使用阴道用乳杆菌活菌胶囊干预3个疗程,对照组不采取任何治疗措施,对比两组阴道微生态失衡率、乳酸杆菌检出率、pH值及女性性功能指数(FSFI)。结果术后2个月、术后3个月两组阴道菌群密度、阴道菌群多样性、pH值及乳酸杆菌数量分级与术前比较,差异有统计学意义(P<0.05),且术后3个月上述指标均较术后2个月明显改善,差异有统计学意义(P<0.05);观察组治疗后阴道微生态失衡率(37.50%)、阴道pH值(4.81±0.26)均低于对照组[70.00%和(5.16±1.02)],差异有统计学意义(P<0.05);观察组阴道乳酸杆菌检出率(97.50%)、FSFI评分[(81.14±1.75)分]高于对照组[57.50%和(75.34±1.18)分],差异有统计学意义(P<0.05)。结论腹腔镜下全子宫切除术可能影响女性阴道微生态菌落,术后2个月微生态环境较差,应用乳酸杆菌活菌胶囊可改善阴道微生态与性生活质量,值得在临床推广应用。

To analyze the effect of laparoscopic hysterectomy on vaginal microflora and the effect of lactobacillus intervention.Methods 80 female patients undergoing laparoscopic hysterectomy in Wuhan University of Science and Technology Hospital from May 2014 to December 2016 were enrolled in the study.The patients were randomly divided into the observation group and the control group,40 cases in each group.The observation group received 3 courses of intervention with Live Lactobacillus Capule for Vsginal Use in 3 months after operation while the control group were not given any treatment.The rate of vaginal microecological imbalance,the detection rate of lactobacillus,pH and female sexual function index(FSFI)were compared between the two groups.Results 2 month and 3 month after operation,there were significant differences in the density of vaginal microflora,the diversity of vaginal microflora,the vaginal pH and the number of vaginal lactobacilli,compared with those before operation(P<0.05).3 month after operation,the above indexes were significantly better than those at 2 month after operation(P<0.05).After treatment,the rate of vaginal microecological imbalance and vaginal pH value were lower in the observation group than the control group[37.50%vs.70.00%,(4.81±0.26)vs.(5.16±1.02)],while the detection rate of vaginal lactobacillus and FSFI score were higher than the control group[97.50%vs.57.50%,(81.14±1.75)vs.(75.34±1.18)](P<0.05).Conclusion Laparoscopic hysterectomy may affect vaginal microflora in the female,especially 2 month after operation,the microecological environment is relatively poor.The application of Live Lactobacillus Capule for Vsginal Use can improve the vaginal microecological environment and the quality of sexual life,which is worth of clinical promotion.