人工流产及放置节育器术后子宫腔内微生物的消长

目的探讨人工流产及放置宫内节育器（ＩＵＤ）术后宫内解脲支原体（ＵＵ）、人型支原体（Ｍｈ）、Ｌ型菌（Ｌ型）、厌氧菌（Ａｎａ）和衣原体（ＣＴ）的消长规律。方法设人工流产、单纯放置ＩＵＤ、放置ＩＵＤ后用青霉素（放置ＩＵＤ＋青霉素）和放置ＩＵＤ后用洁霉素（放置ＩＵＤ＋洁霉素）４组,于术前及术后４个月经周期的经后１周内取宫内吸取物行ＵＵ、Ｍｈ、Ｌ型、Ａｎａ和ＣＴ５种微生物分离鉴定,只要能鉴别出１种,即判定为带菌者。结果术前４组带菌率无差异,术后至第１周期带菌率均最高,以后均为下降趋势,仅单纯放置ＩＵＤ组随周期递增呈线性下降（Ｐ＜０．００１）。人工流产组术后至第１周期与术前比较,差异无显著性（Ｐ＝０．１０５）。同一周期放置ＩＵＤ的３组间无差异,但术后各周期带菌率与术前相比,差异均有显著性（Ｐ＜０．０５）。结论ＩＵＤ存在是宫腔手术后持续带菌的主要因素,机体自然防御机制可清除宫内带菌。放ＩＵＤ后短期内小剂量应用青霉素或洁霉素不足以减少宫内带菌

Investigation of intrauterine microbes after intrauterine operation

Objective To explore the postoperative changes in the cultures of ureaplasma urealyticum (UU), mycoplasma hominis (Mh), L form bacteria (L form), anaerobic bacteria (Ana) and chlamydia trochomatis (CT) after intrauterine operation. Methods Four groups of patients were set up: group 1, induced abortion; group 2, intrauterine device (IUD) insertion; group 3, penicillin i.m. after IUD insertion; group 4, oral lincomycin after IUD insertion. Intrauterine secretion were aspirated to identify the above microbes before operation and within 1 week of ending of menstrual bleeding for 4 consecutive postoperative cycles. Bacteria carrier was defined as at least one of the 5 microbes detected. Results No difference was shown in the incidence of bacteria carrier (IBC) among the 4 groups preoperation. The IBC tended to be the highest in the first menstrual cycle postsurgery in all the 4 groups, then decreased. Compared with preoperation, there were significantly higher IBC in the 3 IUD groups ( P <0.05) except group 1.Conclusion IUD is a major factor for intrauterine microbes existing after operation, and the natural body defense system can help to get rid of the organism by time. Small doses and short period of penicillin or lincomycin administration proved not effective in clearing the intrauterine microbes after IUD insertion.