盆腔炎致病因子及管理措施研究

目的研究东北地区人群盆腔炎(PID)致病因子,同时观察世界卫生组织(WHO)推荐的PID症征处理方法在中国应用的效果.方法对200例P1D病人和155例健康体检的妇女(对照组)分别检测沙眼衣原体(CT)、淋病奈瑟氏菌(NG)、人型支原体(MH)、细菌性阴道病(BV)、阴道毛滴虫(TV)和念珠菌(CA),同时按照WHO推荐的PID病征管理措施给予头孢曲松、多西环素、甲硝唑治疗14天,2～3周后随访,进行体格检查并复查NG以判断疗效.结果 PID病人组MH、BV、CT、CA、TV、NG阳性率分别为26.0%、25.5%、16.0%、10.5%、4.0%、2.5%;正常对照组分别为5.2%、8.4%、0%、5.2%、0.7%、0%,与对照组相比,PID病人组MH、BV、CT阳性率显著高于对照组(P＜0.01);另外200例PID病人混合感染29例(14.5%);200例PID病人复诊137例(复诊率68.5%),其中治愈64例(46.7%),好转68例(49.6%),无效5例(3.7%).结论我国东北地区PID病人与感染MH、BV、CT相关;按照WHO推荐的PID病征管理措施治疗我国东北地区PID病人是非常有效的,特别适用于缺少实验室条件的基层单位.

A Study on the Etiologic Agents of Pelvic Inflammatory Disease and Management

Objective To study the causes of pelvic inflammatory disease(PID) in Shenyang, Northeastern China, and to assess the efficacy of the syndromic management flowchart for PID recommended by World Health Organisation (WHO) in this population. Methods 200 outpatients with PID attending Gynecologic Clinic of No. 1 and No.2 hospital of China Medical University in Shenyang, and 155 control women without symptoms attending an annual workplace based routine medical examination underwent pelvic examination, and were tested for Chlamydia trachomatis(CT), Neisseria gonorrhoeae(NG), Mycoplasma hominis(MH), bacterial vaginosis(BV), Candida albicans(CA) and Trichomonas vaginalis(TV) . Patients with PID were treated with ceftriaxone, doxycycline and metronidazole for 2 weeks as recommended by the World Health Organi-sation(WHO) .Follow - up clinical and laboratory examinations were conducted 2 to 3 weeks after treatment. Results In patients with PID, the prevalence of MH was 26% , of BV 26 % , of CT 16% , of CA 11 % , of TV 4 % and of NG 2.5 % . In the control population, prevalences were 5.2%,8.4%,0%,5.2%,0.7% 0% respectively. The prevalence of MH, BV and CT was significantly higher in PID patients than in the control population ( P < 0.01) .In addition, 29 of 200(14.5% ) patients with PID were polyinfection. 137 of the 200 patients with PID(68.5% )returned for follow - up.Symptoms had resolved completely in 64(47%), and had improved in 68(50% ) . There was no improvement in 5(4%). Conclusion MH, BV and CT are associated with PID in Northeastern China.The syndromic management protocol for female lower abdominal pain recommended by WHO is effective in this gynaecology clinic in China.