女性下生殖道沙眼衣原体及解脲支原体感染与输卵管妊娠的相关性

目的探讨女性下生殖道沙眼衣原体(CT)、解脲支原体(UU)感染与输卵管妊娠发生的关系以及夫妻双方接受敏感抗生素治疗CT、UU感染的输卵管妊娠患者术后输卵管通畅情况。方法 (1)对暨南大学附属第一医院2009年9月至2011年9月135例手术治疗的输卵管妊娠患者(研究组)和68例卵巢囊肿、子宫肌瘤患者(对照组)宫颈分泌物行性传播疾病病原体检测和药敏试验。(2)对有生育要求的65例CT、UU阳性的输卵管妊娠患者根据治疗情况分成夫妻双方同时接受敏感抗生素治疗的治疗组35例和预防性使用抗生素治疗的预防组30例,两组患者在手术当天均预防性使用抗生素,前者再根据药敏试验结果选择敏感抗生素对夫妻双方进行规范治疗,后者手术24h后不再使用抗生素。3个月后行子宫输卵管碘油造影(HSG),检查输卵管通畅情况。结果 (1)研究组CT、UU、CT+UU混合感染、淋病奈瑟菌(NG)检出率分别为19.3%(26/135)、40.7%(55/135)、8.9%(12/135)、3.7%(5/135);对照组CT、UU、CT+UU混合感染、NG的检出率分别为4.4%(3/68)、17.6%(12/68)、0(0/68)、、0(0/68)。两组CT、UU、CT+UU混合感染检出率差异有统计学意义(均P<0.05)。(2)HSG显示敏感抗生素治疗组患者患侧输卵管通畅31例(88.6%),阻塞或通而不畅4例(11.4%);预防性抗生素使用组患者患侧输卵管通畅20例(66.7%),阻塞或通而不畅10例(33.3%)。两组差异有统计学意义(均P<0.05)。结论以CT和UU为主的性传播病原体感染与输卵管妊娠的发生有关;根据药敏试验结果对CT和UU阳性的夫妻加强治疗,可能有助于提高术后3个月的输卵管复通率及减少输卵管妊娠的再发。

Correlational study for CT and UU infection in low genital tract in tubal pregnancy

Objective To study the relationship between lower genital tract infection with CT,UU and tubal pregnancy and to evaluate clinical recanalized effects of treatment for unruptured tubal pregnancy with positive STD by couples sensitive antibiotics or by preventive antibiotics.Methods(1)Cervical secretion samples from 135 patients with tubal pregnancy(experiment group)were used to culture and detect neisseria gonorrhoeae(NG),chlamydia trachomatis(CT)and ureaplasma urealyticum(UU).Comparing with 68 non-tubal pregnancy patients(control group).(2)65 patients with positive of CT and UU were divided into couples sensitive antibiotics treatment group(35 cases)and preventive antibiotics treatment group(30 cases),evaluate the outcome through hysterosalpingogram(HSG)in tubal pregnancy patient after three months post operation.Results(1)In the experiment group the detective rate of CT was 19.3%(26/135),UU was 40.7%(55/135),CT with UU was 8.9%(12/135),NG was 3.7%(5/135).The infected rate of CT,UU and CT with UU in the tubal pregnancy group was significant higher than control group,(P<0.05).(2)The recanalization rate in the tubal pregnancy patients with CT and UU infection who received couples sensitive antibiotics treatment was 88.6%,but The recanalization rate in the tubal pregnancy patients with CT and UU infection who received preventive antibiotics treatment was 66.7%,significant difference between two groups(P<0.05).Conclusion Tubal pregnancy is related to CT and UU.The couples sensitive antibiotics treatment for CT and UU positive ectopic pregnancy patients can improve the rate of recanalization after operation treatment,and may reduce the recurrence of tubal pregnancy.