子宫良性病变行子宫切除术前阴道微生态检测的临床价值

The clinical value of detection of vaginal micro-ecological status before hysterectomy with benign uterine lesions

目的探讨子宫良性病变行子宫切除术前阴道微生态检测的临床价值。方法回顾性分析2016年1月至2017年12月在厦门市妇幼保健院妇科因子宫良性病变行腹腔镜子宫切除、资料完整的病例453例,术前检测阴道微生态及宫颈高危HPV感染情况。结果453例患者阴道微生态正常152例(33.55%),微生态失衡69例(15.23%),细菌性阴道病(BV)132例(29.14%),外阴阴道假丝酵母菌病(VVC)45例(9.93%),滴虫性阴道炎(TV)25例(5.52%),需氧菌性阴道炎(AV)16例(3.53%),混合性阴道炎(MVI)14例(3.09%)。宫颈高危型HPV感染107例,其中微生态正常30例(28.04%),微生态失衡19例(17.76%),BV 39例(36.45%),VVC 10例(9.35%),TV 5例(4.67%),MVI 4例(3.74%)。结论宫颈高危型HPV感染与BV感染具有相关性(P<0.05),而与其他感染无相关性(P>0.05)。子宫切除术前行阴道微生态检测,不仅可明确阴道微生态状况,而且可针对性的进行治疗,从而减少围手术期感染的发生,并为术后生殖道炎症的治疗和随诊提供良好的评判指标。

Objective To explore the clinical value of vaginal microecosystem before hysterectomy with benign uterine lesions. Methods Retrospective analysis was performed on the detailed data of 453 patients with benign uterine lesions who accepted hysterectomy in our hospital from January 2016 to December 2017;their statuses of vaginal microecosystem and high risk HPV cervical infection were detected before the surgery. Results Among the 453 cases, there were 152(33.55%) patients with normal vaginal microecosystem(33.55%), 69 patients with disordered vaginal microecosystem(15.23%), 132 patients with bacterial vaginosis(BV)(29.14%), 45 patients with vulvovaginal candidiasis(VVC)(9.93%), 25 patients with trichomonas vaginitis(TV)(5.52%), 16 patients with aerobic vaginitis(AV)(3.53%), and 14 patients with mixed infection(3.09%). In the 107 cases of HPV infection, there were 30 cases of normal microecosystem(28.04%), 39 cases of BV(36.45%), 10 cases of VVC(9.35%), 5 cases of TV(4.67%) and 4 cases of mixed infection(3.74%). Conclusion HPV infection has a close correlation with BV infection(P<0.05) but is not correlated with other infections(P>0.05). Thus, detection of vaginal microecosystem status before hysterectomy can not only define the vaginal micro-ecological status, but contribute to individualized treatment, which helps to reduce perioperative infections greatly and supports valuable indication for urethritis treatment and follow-up after operations.