妇女孕期下生殖道微生态失衡及感染的临床分析

目的：了解妊娠期妇女阴道微生态情况及妊娠合并下生殖道感染的致病菌，高危型人乳头瘤病毒（ HPV）的分布状况，探讨妊娠期妇女阴道微生态环境的改变。方法对1874例行产前检查的妊娠期妇女采集阴道分泌物，涂片，湿片检查滴虫、霉菌及清洁度；应用细菌性阴道病检测试剂盒行细菌性阴道病联合测定并监测女性生殖道微生态平衡状态；对存在下生殖道感染的症状体征者进行病原学检查。结果在1874例妊娠期妇女中，存在阴道微生态失调的有1225人（占65．37％）；存在下生殖道感染症状体征且病原学检查为阳性者为540人（占28．82％），其中存在1种病原感染者380例，占感染组的70．37％；存在2～3种病原感染者160例，占感染组的29．63％。单纯型下生殖道感染中常见的病原体是解脲支原体（41．58％）、细菌性阴道病（22．11％）、假丝酵母菌（9．74％）；混合型下生殖道感染中常见的病原体是解脲支原体（60．00％）、假丝酵母菌（58．13％）、细菌性阴道病（44．38％）。结论妊娠期阴道微生态失调及下生殖道感染发生率较高，妊娠期下生殖道感染以解脲支原体较常见，其次是混合型感染及其他。

Clinical analysis of lower genital tract microecological imbalance and infection in pregnant woman

Objective To explore the lower genital tract microecological imbalance of pregnant woman and the distribution of pathogenic bacteria or high-risk HPV in them.Methods Vaginal secretions were collected from 1 874 cases taking prenatal examination and smeared to check infusorium , mycetes and cleanliness .Bacterial vaginal disease detection kit was used to check the distribution of pathogenic bacteria and their vaginal microecosystem , and etiological examinations were taken for those with lower genital tract infection .Results There were 1 225 cases （65.37%） with vaginal microecological imbalance , and 540 cases （28.82%） with signs and symptoms of lower genital tract infection and positive etiological examinations , including 380 （70.37%） with one pathogenic bacterium and 160 （29.63%） with two or more pathogenic bacteria.The most common pathogens were mycoplasma urealytium （41.58%）, bacterial vaginosis （22.11%） and candida mycoderma bacteria （9.74%）.The most common pathogens in mixed lower genital tract infection were mycoplasma urealytium （60.00%）, candida mycoderma bacteria （58.13%） and bacterial vaginosis （44.38%）.Conclusion Pregnant women have high incidence rate of vaginal microecological imbalance and lower genital tract infection , and the most common pathogeny is mycoplasma urealytium, followed by mixed infection and others .