不同分娩方式产后6～8周产妇阴道微生态失衡的相关因素分析

目的了解产妇产后6～8周阴道菌群的改变,探讨产褥期阴道微生态的变化及相关影响因素。方法选择2009年1月至2009年11月北京积水潭医院妇产科足月分娩的304例产妇,以不同的分娩方式分为两组,剖宫产组(186例)及阴道分娩组(118例),对其产后6～8周的阴道分泌物进行常规检查、细菌培养、细菌性阴道炎(BV)、pH值及性激素水平的检测,并记录其产褥期血性恶露干净时间、哺乳及活动情况。结果剖宫产组及阴道分娩组血性恶露干净时间分别是(31.95±8.63)d及(31.60±9.15)d,两组比较,差异有统计学意义(P>0.05);两组产妇pH值异常者分别占97.1%(167/172)和94.9%(112/118);pH值异常组BV阳性率(40.05%,140/304)明显高于pH值正常组(2.30%,7/304),两组比较,差异有统计学意义(P<0.01)。剖宫产组及阴道分娩组BV发病率分别为48.39%(90/186)和48.31%(57/118),两组比较,差异无统计学意义(P>0.05)。结论女性产褥期阴道微生态严重失衡,pH值明显异常,不同分娩方式BV发生率无差异。

A correlation study of post-delivery vaginal ecosystems after different modes of delivery

Objective To discover the change of the bacterial flora in the vagina after puerperium and it＇s related factors. Methods 304 women who labored in our hospital from January 2009 to November 2009 were included in this study, among them 186 were cesarean delivery （CS） and 118 cases were vaginal delivery. We examined their vaginal secretion by microscopy, germiculture, BV test and pH value. Information of sex hormone, diet, exercise out of the bed and the time of lochia disappearing in puerperium were recorded. Results The time of bloody lochia was （31.95±8. 63） d in cesarean section group and and （31.60±9.15）d in vaginal delivery group （P~0. 05）, The ecological conditions appeared to be unbalanced, the pH value increased and the positive rate of BV test raised and there had no significant difference between the two groups. The positive rate of BV test in those with abnormal pH value was much higher than that with normal pH value （P〈0.01）. Conclusion The vaginal ecological condition is badly unbalanced during the period of puerperium with a high incidence of BV but has no correlation with the mode of delivery.