女性在分娩前与分娩后的阴道微生态情况分析

Analysis of Vaginal Microecology of Women before and after Delivery

目的:分析女性在分娩前与分娩后的阴道微生态情况。方法:选取乐山市市中区人民医院2019年12月-2020年10月在分娩前1周内进行阴道微生态检测的女性58例,其中25例分娩后进行阴道微生态检测。阴道微生态检测包括形态学检测及功能学检测。分析分娩前后女性阴道微生态整体情况,分娩前后阴道分泌物形态学检测情况及功能学检测情况。结果:分娩前58例均处于阴道微生态失调状态,7例(12.1%)诊断患阴道感染性疾病,其中6例(10.3%)诊断为外阴阴道假丝酵母菌病,1例(1.7%)诊断为细菌性阴道病。分娩后25例均处于阴道微生态失调状态,4例(16.0%)诊断患阴道感染性疾病,其中2例(8.0%)诊断为外阴阴道假丝酵母菌病,1例(4.0%)诊断为滴虫阴道炎,1例(4.0%)诊断为细菌性阴道病。分娩前女性阴道优势菌为大杆菌的占比高于分娩后(89.7%vs 64.0%),优势菌为短小杆菌或球菌的占比低于分娩后(P<0.05),分娩前后女性菌群密集度、菌群多样性、是否查见真菌及滴虫比较差异均无统计学意义(P>0.05)。分娩前白细胞酯酶阴性占比高于分娩后(44.8%vs 16.0%),弱阳性和阳性占比低于分娩后(55.2%vs 84.0%)(P<0.05),分娩前后女性pH值、乙酰氨基葡萄糖苷酶、β-葡萄糖醛酸酶、唾液酸苷酶、过氧化氢比较差异均无统计学意义(P>0.05)。结论:妊娠期与产褥期女性极其容易出现阴道微生态失衡状态,分娩对女性阴道微生态有一定影响,应及时监测阴道微生态情况,关注女性分娩前后阴道微生态健康。

Objective:To analyze the vaginal microecology of women before and after delivery.Method:From December 2019 to October 2020,58 women who underwent vaginal microecological testing within one week before delivery and 25 women of them who underwent vaginal microecological testing after delivery were selected from People’s Hospital of Shizhong District of Leshan.Vaginal microecology test included morphological detection and functional detection.The overall situation of woman vaginal microecology before and after delivery,the morphological and functional test condition of vaginal secretions before and after delivery were analyzed.Result:Before delivery,58 cases were in vaginal microecological disorder,7 cases(12.1%)were diagnosed with vaginal infectious diseases,of which 6 cases(10.3%)were diagnosed with vulvovaginal candidiasis and 1 case(1.7%)was diagnosed with bacterial vaginosis.After delivery,25 cases were in vaginal microecological disorder,4 cases(16.0%)were diagnosed with vaginal infectious diseases,of which 2 cases(8.0%)were diagnosed with vulvovaginal candidiasis,1 case(4.0%)was diagnosed with trichomonal vaginitis,and 1 case(4.0%)was diagnosed with bacterial vaginosis.The proportion of dominant bacteria of macrobacterium in the vagina of women before delivery was higher than that in women after delivery(89.7%vs 64.0%)(P<0.05),the proportion of dominant bacteria of bacillus pumilus or cocci was lower than that after delivery(P<0.05),but there were no significant differences in flora density,flora diversity,whether fungi and trichomonas were found between women before and after delivery(P>0.05).The proportion of leukocyte esterase negative before delivery was higher than that after delivery(44.8%vs 16.0%),and the proportion of weak positive and positive was lower than that after delivery(55.2%vs 84.0%)(P<0.05),while there were no statistically significant differences in pH value,acetaminoglycosidase,β-glucuronase,sialidase and hydrogen peroxide(P>0.05).Conclusion:Women in pregnancy and puerperium are extremely prone to vaginal microecological imbalance.Childbirth has a certain impact on women’s vaginal microecology.We should timely monitor the vaginal microecology and pay attention to the health of women’s vaginal microecology before and after childbirth.