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目的探讨乳酸杆菌对维持妊娠期下生殖道稳态的作用,预防胎膜早破的效果。方法选取在唐山市妇幼保健院产科门诊进行孕期检查的妊娠中晚期单胎孕妇,常规阴道分泌物高倍镜检筛查出乳酸杆菌阴性的阴道微生态失调病例186例,将是否能接受乳酸杆菌治疗分为干预组132例及对照组54例。干预组孕妇每晚睡前清洁外阴后阴道后穹窿上药乳酸杆菌胶囊1粒,连用10d,10d后复查阴道分泌物高倍镜检,对照组未进行任何药物干预治疗。观察干预组阴道微生态变化,包括pH值、乳酸杆菌阳性率、清洁度变化,以及二组胎膜早破的发生率。结果干预组治疗后阴道分泌物高倍镜检提示阴道pH值(3.96±0.14)较前(4.81±0.16)明显下降,乳酸杆菌阳性率105例(79.54%),阴道分泌物清洁度有76.51%(101/132,P<0.01)恢复到正常水平。干预组妊娠结局胎膜早破发生率明显低于对照组(P<0.05)。结论在妊娠中晚期应用乳酸杆菌能有效改善阴道微生态失调,恢复下生殖道稳态,降低胎膜早破发生率。减少妊娠期抗生素使用。
Objective To investigate the effect of lactobacillus on the maintenance of the lower reproductive tract during pregnancy and to prevent the premature rupture of membranes. Methods Totally 186 pregnant women with single-pregnancy during the second trimester of pregnancy who were examined during pregnancy in obstetrics and gynecology clinic of Maternal and Child Health Hospital of Tangshan City were enrolled in this study. 186 cases of vaginal microecological disorders negative of Lactobacillus were detected by conventional vaginal secretions high-power microscopic examination. Divided into intervention group 132 cases and control group 54 cases. Intervention group, pregnant women every night before going to bed to clean the vulva vaginal fornix on the Lactobacillus capsule 1, once every 10d, 10d after the review of vaginal secretions high power microscopy, the control group without any drug intervention. The changes of vaginal microflora in the intervention group were observed, including pH value, the positive rate of lactobacilli, the change of cleanliness, and the incidence of premature rupture of membranes in the second group. Results The high magnification of the vaginal secretions in the intervention group showed that the vaginal pH (3.96 ± 0.14) was significantly lower than that of the former (4.81 ± 0.16), the positive rate of lactobacilli was 79.54% and the vaginal discharge was 76.51% 101/132, P <0.01) returned to normal levels. The incidence of preterm premature rupture of membranes in intervention group was significantly lower than that in control group (P <0.05). Conclusion The application of Lactobacillus in the second trimester of pregnancy can effectively improve vaginal microflora imbalance and restore the lower reproductive tract homeostasis and reduce the incidence of premature rupture of membranes. Reduce the use of antibiotics during pregnancy.