乳酸菌阴道胶囊干预对孕晚期细菌性阴道病患者阴道菌群及分娩结局的影响

Effects of lactobacillus vaginal capsule intervention on vaginal flora and delivery outcome in patients with advanced bacterial vaginosis

目的探讨乳酸菌阴道胶囊干预对孕晚期细菌性阴道病(BV)患者阴道菌群及分娩结局的影响。方法2017年12月-2019年2月在泰山医学院附属青岛医院接受治疗及分娩的BV患者136例,参照随机数表法分为对照组、研究组各68例。对照组患者接受甲硝唑治疗,研究组患者接受乳酸菌阴道胶囊+甲硝唑治疗。持续1周后,对比两组患者的疗效、乳酸菌计数情况、用药不良反应发生情况的差异,记录两组患者分娩结局。结果治疗1周后,两组患者的疗效分级差异有统计学意义(U=7.062、P=0.029);治疗总有效率的差异无统计学意义(χ^2=2.030、P=0.154)。两组患者的阴道乳酸菌计数分级差异有统计学意义(U=9.179、P=0.047),研究组患者的乳酸菌计数正常率高于对照组患者(χ^2=6.103、P=0.013)。用药期间,两组患者皮肤瘙痒、下腹疼痛、头晕头痛等不良反应发生率差异无统计学意义(χ^2=0.341、1.007、0.208,P=0.559、0.316、0.649)。两组患者均无一例发生心律失常。研究组患者的胎膜早破、早产、产褥感染、子宫内膜炎发生率低于对照组患者(χ^2=4.087、4.561、3.765、4.121,P=0.043、0.033、0.049、0.042)。两组患者的新生儿感染、新生儿高胆红素血症发生率差异无统计学意义(χ^2=2.030、2.944,P=0.154、0.086)。结论乳酸菌阴道胶囊干预对优化孕晚期BV患者阴道菌群、改善妊娠结局具有一定积极作用。

Objective To investigate the effect of lactobacillus vaginal capsule intervention on vaginal flora and delivery outcome in patients with advanced bacterial vaginosis(BV).Methods 136 pregnant woman with BV during later stage in our hospital from December 2017 to February 2019 were randomly divided into Control group or Research group(n=68).The patients in control group were treated with Metronidazole while those in research group were treated with lactobacillus vaginal capsule and Metronidazole.After a week of treatment,the efficacy,Lactobacillus count and adverse drug reactions in the two groups were compared,and the outcomes of childbirth were recorded.Results There was statistically significant difference in the efficacy grading between two groups(U=7.062,P=0.029).The difference in total efficiency rate was not statistically significant(χ^2=2.030,P=0.154).The difference in lactobacillus count grading between two groups was statistically significant(U=9.179,P=0.047),with research group superior to control group(χ^2=6.103,P=0.013).During the treatment,there were no statistically significant differences in the incidences of adverse reactions including pruritus,abdominal pain,dizziness and headache between the two groups(χ^2=0.341,1.007,0.208;P=0.559,0.316,0.649).No arrhythmia occurred in either group.The incidences of premature rupture of membranes,preterm birth,puerperal infection and endometritis in research group were lower than those in control group(χ^2=4.087,4.561,3.765,4.121;P=0.043,0.033,0.049,0.042).There were no statistically significant differences in the incidences of neonatal infection and neonatal hyperbilirubinemia between groups(χ^2=2.030,2.944;P=0.154,0.086).Conclusion Intervention of lactobacillus capsule has certain positive effect for optimizing the vaginal flora and improving the pregnancy outcome of BV patients in the third trimester.