改善围绝经期妇女阴道微生态环境在阴道镜检查中的临床分析

Clinical analysis of improving vaginal microecological environment in perimenopausal women during colposcopy

目的研究改善围绝经期妇女阴道微生态环境在阴道镜检查中的具体情况。方法选取567例参加免费宫颈癌筛查液基薄层细胞学检查(TCT)结果为意义不明确的非典型鳞状细胞(ASC-US)围绝经期妇女,治疗前后行阴道镜检查,均给予抗厌氧菌药物,根据妇女阴道镜各项检查结果分为改善组(431例)和未改善组(136例)。比较两组治疗前后阴道优势菌计数、过路菌计数、治疗前后阴道微生态功能学、醋酸白试验阳性率及碘试验阳性率。结果治疗前,两组优势菌计数、过路菌计数水平比较,差异无统计学意义(P>0.05);治疗后改善组优势菌计数、过路菌计数水平优于未改善组(P<0.05)。改善组的过氧化氢(H_(2)O_(2))pH、白细胞酯酶(LE)阳性率分别为47.10%、33.64%、43.85%,均低于未改善组的73.53%、72.06%、63.24%(P<0.05)。治疗前,两组醋酸白试验阳性率、碘试验阳性率比较,差异无统计学意义(P>0.05);治疗后,两组醋酸白试验阳性率、碘试验阳性率比较,差异有统计学意义(P<0.05)。结论改善围绝经期妇女阴道微生态环境,在阴道镜检查中发现可增加优势菌计数,改善阴道微生态功能学,使阴道pH更趋向稳定,值得临床推广。

Objective To study the improvement of vaginal microecological environment in perimenopausal women during colposcopy.Methods A total of 567 perimenopausal women with atypical squamous cell(AsC-US)whose results were unclear in the free TCT of cervical cancer screening were selected.They underwent colposcopy before and after treatment and were given anti-anaerobic drugs.According to the results of colposcopy,the patients were divided into an improved group(431 cases)and a non-improved group(136 cases).The vaginal dominant flora count,passing flora count,vaginal microecological function,positive rate of acetic acid white test and iodine test were compared between the two groups before and after treatment.Results Before treatment,there were no significant differences in the levels of dominant bacteria count and passing bacteria count between the two groups(P>0.05).After treatment,the levels of dominant bacteria count and passing bacteria count in the improved group were better than those in the non-improved group(P<0.05).The positive rates of hydrogen peroxide(H_(2)O_(2)),pH and leucocyte esterase(LE)in the improved group were 47.10%,33.64%and 43.85%,respectively,which were lower than 73.53%,72.06%and 63.24%in the non-improved group(P<0.05).Before treatment,there were no significant differences in the positive rates of acetic acid white test and iodine test between the two groups(P>0.05).After treatment,the positive rates of acetic acid white test and iodine test were compared between the two groups,the difference is statistically significant(P<0.05).Conclusion Improving the vaginal microecological environment of perimenopausal women can increase the count of dominant bacteria,improve the vaginal microecological function,and make the vaginal pH more stable,which is worthy of clinical promotion.