连续3年动态观察某三甲医院女性阴道分泌物五联干化学和镜检联合筛查细菌性阴道病的意义

Significance of combined screening for bacterial vaginosis by five-joint chemical and microscopic examinations of female vaginal secretions in a third-grade A hospital for three consecutive years

目的连续3年对相同女性医务人员阴道分泌物进行五联干化学和镜检联合检测,了解生殖道感染情况,为对女性医务人员阴道疾病筛查、预防及临床治疗提供参考依据。方法对2016年-2018年在本院体检阴道分泌物的女性医务人员1284例,采用干化学法检测SNA、LE、NAG,并进行湿片显微镜观察镜检线索细胞、真菌、滴虫及清洁度判断,对镜检出现真菌、滴虫及细菌异常的标本进行革兰染色。结果2016年-2018年,女性医务人员NAG检测真菌和滴虫阴道炎阳性率分别为52.3%、54.2%、72.4%;湿片和革兰染色显微镜检测真菌阳性率分别为3.04%、3.89%,4.91%;湿片显微镜检测滴虫阳性率分别为0.08%、0.39%,0.62%。连续3年LE(3+以上)和清洁度Ⅲ度以上检测BV率分别为26.8%、33.8%、34.6%和12.2%、17.1%、24.5%。结论女性医务人员(特别护理人员)阴道感染健康状况不容乐观,需要进行针对性的健康教育、按时进行体检评估和治疗,减少阴道感染疾病发生。

Objective For three consecutive years,the vaginal secretions of the same female medical staff were jointly tested by five combined chemical and microscopic examinations to understand the situation of genital tract infections,and provide a reference for the screening,prevention,and clinical treatment of vaginal diseases of female medical staff.Methods From 2016 to 2018,1234 female medical workers who examined vaginal secretions in our hospital for three consecutive years were examined by dry chemical method.Three enzymatic indices:sialidase(SNA),leucocyte esterase(LE),Acetylglucosaminidase(NAG)were detected simultaneously,and the clue cells,fungi,trichomonas and cleanliness were observed by wet-film microscopy(observation).Leukocyte,epithelial cell,bacillus and coccus were stained with Gram's staining for specimens with fungi,trichomonas and bacterial abnormalities.Results From 2016 to 2018,the positive rates of fungi and trichomonas vaginitis detected by NAG in female medical staff were 52.3%,54.2% and 72.4%,respectively;the positive rates of fungi detected by wet slice and Gram staining microscopy were 3.04%,3.89%,4.91%,respectively;the positive rates of trichomonas detected by wet slice microscopy were respectively 0.08%,0.39%,0.62%.For three consecutive years,the detection rates of BV for LE(above 3+)and cleanliness Ⅲ were 26.8%,33.8%,34.6%and 12.2%,17.1% and 24.5%,respectively.Conclusion Female medical workers(special nurses)have high work intensity,long working hours and unoptimistic health status of vaginal infection.They need targeted health education,timely physical examination evaluation and treatment to reduce the occurrence of vaginal infection diseases.