544例北京市人工流产女性术前阴道微生态状况分析

Analysis of vagina microecology of 544 women before induced abortion in Beijing

目的分析544例北京市人工流产女性术前阴道微生态状况。方法回顾性分析2018年1月至2019年3月北京市丰台区妇幼保健计划服务中心接收的544例人工流产患者的临床资料,术前取阴道分泌物进行阴道微生态分析。观察所有患者的阴道状况;观察阴道微生态失衡患者的感染情况;观察不同年龄组患者阴道单一感染、混合感染情况;分析阴道微生态失衡患者的临床症状。结果 544例患者中,阴道清洁度Ⅱ度的占比(55.88%)高于Ⅰ、Ⅲ、Ⅳ度;pH值<4.5的占比(75.37%)高于pH值≥4.5;微生态平衡的占比(68.01%)高于微生态失衡(P <0.05);阴道微生态失衡共174例,其中单一感染93例,阳性率为17.10%,混合感染81例,阳性率为14.89%,单一感染中AV感染率最高(6.99%),混合感染中BV+AV感染率最高(11.21%);单一感染20~29岁患者以AV、BV感染多见,30~39岁患者以AV、VVC感染多见,≥40岁患者以VVC感染多见;混合感染20~29岁、30~39岁患者以BV+AV感染多见;174例阴道微生态失衡患者中,无症状者112例(64.37%),有症状者62例(35.63%);与<20岁比,20~29岁、30~39岁患者AV阴道单一感染率高(P<0.05);不同年龄组患者VVC阴道单一感染率相比,差异有统计学意义(P<0.05);与<20岁、20~29岁比,30~39岁患者BV+AV阴道混合感染率高(P<0.05);与30~39岁比,≥40岁患者BV+AV阴道混合感染率低(P<0.05);不同年龄组患者VVC+AV阴道混合感染率相比,差异有统计学意义(P <0.05);不同年龄组患者BV、AV、TV阴道单一感染率相比,差异无统计学意义(P> 0.05);不同年龄组患者BV+AV、多重感染阴道混合感染率相比,差异无统计学意义(P> 0.05)。结论早孕期人工流产术前阴道微生态失衡发生率较高,应重视人工流产术前的阴道微生态检测,防止发生感染。

Objective To analyze the vaginal microecology of 544 women before induced abortion in Beijing.Methods The clinical data of 544 induced abortion patients received by Beijing Fengtai District Maternal and Child Health Care Family Planning Service Center from January 2018 to March 2019 were retrospectively analyzed,and vaginal secretions were collected before operation for vaginal microecological analysis.To observe the vaginal condition of all patients.To observe the infection of patients with vaginal microecological imbalance.To observe the single infection and mixed infection of vagina of patients in different age groups.To analyze the clinical symptoms of vaginal microecological imbalance.Results Among 544 patients,the proportion of vaginal cleanliness degree II(55.88%)was higher than that of degrees I,III,and IV;the proportion of pH<4.5(75.37%)was higher than that of pH≥4.5;the proportion of microecological balance(68.01%)was higher than the microecological imbalance(P<0.05).There were 174 cases of vaginal microecological imbalance,93 cases of single infection and the positive rate was 17.10%,81 cases of mixed infection and the positive rate was 14.89%,the highest AV infection rate was found in single infection(6.99%),the highest BV+AV infection rate was found in mixed infection(11.21%).AV,BV infection was more common in patients aged 20~29 years with single infection,AV,VVC infection was more common in patients aged 30~39 years,VVC infection was more common in patients aged≥40 years;BV+AV infection was more common in patients with mixed infection aged 20~29 years and 30~39 years;Among 174 cases of vaginal microecological imbalance patients,112 cases(64.37%)were asymptomatic,and 62 cases(35.63%)were symptomatic.Compared with<20 years old,the single infection rate of AV vagina was higher in patients aged 20~29 years old and 30~39 years old(P<0.05).The single infection rate of VVC in different age groups was statistically significant(P<0.05).Compared with<20 years old and 20~29 years old,the mixed infection rate of BV+AV was higher in 30~39 years old(P<0.05).Compared with 30~39 years old,the mixed infection rate of BV+AV was lower in≥40 years old(P<0.05).The mixed vaginal infection rate of VVC+AV in different age groups was statistically significant(P<0.05).There was no significant difference in single vaginal infection rate of BV,AV,TV among patients of different age groups(P>0.05).There was no significant difference in the rate of BV+AV and the rate of vaginal mixed infection in different age groups(P>0.05).Conclusion The incidence of vaginal microecological imbalance before induced abortion in early pregnancy is relatively high,so the detection of vaginal microecological imbalance before induced abortion should be paid attention to prevent infection.