130例性传播疾病性尿道炎的诊断与治疗

目的 探讨性传播疾病性尿道炎(STU)病原体混合感染的诊断与治疗.方法 130例男性STU患者取尿道分泌物或前列腺液,检测衣原体属采用胶体金法,支原体属采用泌尿生殖道病原性支原体药敏定量培养板行分泌物培养,检测淋菌等采用革兰染色法或培养法,治疗急性尿道炎主要采用广谱抗菌药物注射用头孢哌酮/他唑巴坦2.25g或注射用氟氧头孢钠1.0g,均静脉滴注,2次/d×7d,根据化验结果,如合并衣原体属、支原体属感染加用红霉素和甲硝唑片.结果 单纯淋菌感染31例占23.8％,衣原体感染28例占21.5％,支原体属感染21例占16.2％,衣原体属+支原体属感染16例占12.3％,淋菌+衣原体属+支原体属感染29例占22.3％,另有3例占2.3％阴道加德纳菌感染,真菌感染2例占1.5％,多种病原体混合感染45例占34.6％；平均随访11个月,首次发病治愈120例占92.3％,另有10例占7.9％无效的患者均为复发病例,同时合并尖锐湿疣、生殖器疱疹各3例,梅毒、真菌感染各2例,未发现合并人类免疫缺陷病毒(HIV)感染者.结论 STU治疗的难点是多种病原体混合感染的流行趋势,联合应用抗菌药物、抗衣原体属、支原体属药物及胸腺肽、干扰素等增强机体免疫力制剂,是系统治疗STU的有效方法.

Diagnosis and treatment of sexually transmitted urethritis of 130 patients

OBJECTIVE To explore the diagnosis and treatment of sexually transmitted urethritis with multiplicity organisms.METHODS The urethral secretions or prostatic fluid samples of 130 STU patients were collected.Chlamydia was detected by colloidal gold method,rogenital pathogenic Mycoplasma susceptibility quantitative plate was adopted for secretion culture of Mycoplasma,and gram′s staining or culture method was used to detect Neisseria gonorrhoeae.This group was injected with cefoperazone sodium and tazobactam for 2.25g,VD,twice a day for seven days or flomoxef sodium 1.0g,VD,twice a day for seven days.According to the laboratory test results,the patients infected with Chlamydia and Mycoplasma were administrated with erythromycin tablet and meyronidazole.RESULTS Single Neisseria gonorrhoeae infection,Chlamydia infection,Mycoplasma infection were found in 31 cases(23.8%),28 cases(21.5%),21cases(16.2%),respectively.Chlamydia infection plus Mycoplasma infection was detected in 16 cases(12.3%),Neisseria gonorrhoeae infection plus Chlamydia plus Mycoplasma in 29 cases(22.3%),Gardmerella infection in 3 cases(2.3%)and fungal infections in 2 cases(1.5%).The mixed infections caused by multiple pathogens was found in 45 cases(34.6%).Curative effect:during the average follow-up for 11 months,120 cases were cured for the first onset,accounting for 92.3%;10 cases were recurrent,accounting for 7.9%,3 cases were Condyloma combined with genital herpes,2 cases were syphilis and 2 cases were fungal infections.No HIV-infected patients were found.CONCLUSION The prevalence of mixed infection caused by multiple pathogens makes the treatment of STU difficult.Combined use of antibiotics,anti-Chlamydia and Mycoplasma drugs,thymosin and interferon is an effective way to treat STU.