基于致病菌耐药性合理选择抗菌药物治疗老年性阴道炎的临床疗效分析

Analysis of Clinical Efficacy of Rational Selection of Antimicrobial Agents Based on Drug Resistance of Pathogenic Bacteria in the Treatment of Elderly Vaginitis

目的探讨在老年性阴道炎患者进行致病微生物检验后,基于致病菌耐药性合理选择抗菌药物治疗老年性阴道炎的意义。方法选取2017年10月-2019年10月在广元市第三人民医院住院治疗的老年性阴道炎患者100例,根据随机数字表法分为观察组(n=50)和对照组(n=50)。对照组患者每天用1%的乳酸液冲洗阴道和外阴,用棉球拭净后阴道放置甲硝唑阴道泡腾片治疗;观察组患者在进行致病微生物检验后,根据致病菌耐药性合理选择抗菌药物。评估并比较2组治疗前后症状和体征的变化,以及2组疗效。结果在治疗前,2组老年性阴道炎患者存在的临床症状和体征(外阴瘙痒、外阴疼痛、阴道壁充血和水肿、阴道分泌物较多)均无统计学差异(P>0.05);在治疗后,2组的临床症状和体征进行比较,除外阴疼痛外均有统计学差异(P<0.05);对照组的有效率为82%,观察组的有效率为96%,2组间疗效比较具有统计学差异(P<0.05)。在3次随访时,对照组的有效率分别是74%、68%和60%,观察组分别是92%、86%和82%,3次随访的比较均有统计学差异(P<0.05);复发率在对照组分别是8%、14%和24%,在观察组分别是4%、10%和14%,第3次随访的比较有统计学差异(P<0.05)。结论老年性阴道炎患者进行致病菌微生物检验后,合理选择抗菌药物能够有效减轻患者存在的临床症状和体征,提高临床疗效,具有一定的临床指导价值。

Objective To explore the significance of rational selection of antibiotics for the treatment of elderly vaginitis based on the drug resistance of the pathogenic bacteria after the pathogenic microorganismtest in patients with elderly vaginitis.Methods A total of 100 patients with elderly vaginitis admitted to Third People's Hospital of Guangyuan City from October 2017 to October 2019 were selected.According to the randomnumber table method,they were divided into observation group and control group,with 50 ones in each group.In the control group,the vagina and vulva of patients were washed with 1%lactic acid solution and then metronidazole vaginal effervescent tablets were placed into their vagina every day.In the observation group,the patients were given antibiotics according to the drug resistance of pathogenic bacteria after the examination of pathogenic microorganisms.The changes in symptoms and signs of patients before and after treatment were evaluated and compared between the two groups,and the efficacy was also compared between the two groups.Results Before treatment,there was no significant difference in clinical symptoms and signs(pruritus vulvae,vulva pain,vaginal wall congestion and edema,more vaginal secretions)between the two groups(P>0.05).After treatment,except for vulva pain,the clinical symptoms and signs of the two groups were statistically different(P<0.05).The effective rate of the control group was 82%and the observation group was 96%,there was statistical difference between the two groups(P<0.05).At the three followups,the effective rates of the control group were 74%,68%,and 60%,and the observation group were 92%,86%,and 82%,respectively.There were statistical differences in the comparison of the 3 follow-ups between the two groups(P<0.05).At the three follow-up,the recurrence rate was 8%,14%,and 24%in the control group,and 4%,10%,and 14%in the observation group,respectively.There was a statistical difference in the third follow-up comparison(P<0.05).Conclusions Patients with elderly vaginitis should reasonably choose antibacterial drugs based on the results of pathogenic bacteria detection,which can effectively reduce the clinical symptoms and signs of patients and improve clinical efficacy.