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目的研究产后6~8周妇女阴道微生物环境的变化特征及阴道菌群失衡的发病率,探讨应用阴道乳杆菌胶囊恢复产后妇女阴道内环境,预防生殖道感染发生的临床意义。方法收集1 053例产妇产后6~8周回访就诊时阴道分泌物,采用革兰染色法检查,进行Nugent评分,按Nugent评分系统对菌群分类,进一步诊断细菌性阴道病(BV),并与其孕早期产检时情况比对。结果 1 053例产后6~8周妇女Nugent评分正常521例,临界242例,有290例发生阴道炎症,细菌性阴道病205例,阴道假丝酵母菌74例和滴虫11例。疾病构成比以非特异性阴道炎为主,特异性阴道炎较为少见。所有妇女阴道p H均在5.0以上。在所有涂片中,被认为在维持正常阴道微生态平衡中起关键作用的乳杆菌数量和比例明显不足。产后BV的发病率(31.36%)高于孕早期产检时,产后妇女BV发病率较高,差异有统计学意义(P<0.05)。予300例患者阴道内放置乳酸杆菌活菌胶囊,结果显示研究组阴道p H明显降低,接近正常女性阴道p H水平(P<0.05),且阴道乳酸杆菌数量明显增多(P<0.05);同时产后3个月、6个月阴道炎的发生率均明显低于对照组(P<0.05)。结论产后妇女阴道乳酸杆菌量减少,菌群比例明显失调。阴道炎症以非特异性阴道炎为主,细菌性阴道病、真菌性阴道炎和滴虫性阴道炎较少见。乳杆菌胶囊作为生态治疗的活菌制剂,既能预防、治疗阴道感染,又无不良反应,还可以减少产后妇女阴道炎的复发率,值得临床推广应用。
Objective To study the change characteristics of vaginal microbe environment and the prevalence of vaginal flora in postpartum women from 6 to 8 weeks postpartum and to explore the clinical significance of using vaginal lactobacillus capsule to restore vaginal environment of postpartum women and prevent the occurrence of reproductive tract infections. Methods One hundred and fifty-three maternal vaginal discharges were collected at 6-8 weeks of postnatal visit. Gram stain was used to evaluate the vaginal discharge. The Nugent score was scored. The Nugent scoring system was used to classify the germs and to further diagnose bacterial vaginosis (BV) Pregnancy early pregnancy check when compared. Results 1 053 women with postnatal 6-8 weeks nugent score 521 cases of normal, 242 cases of critical, there were 290 cases of vaginal inflammation, bacterial vaginosis in 205 cases, 74 cases of Candida vaginalis and trichomoniasis in 11 cases. The ratio of disease to non-specific vaginitis-based, specific vaginitis is rare. All women with vaginal p H 5.0 or more. In all smears, the number and proportion of lactobacilli considered to be key in maintaining normal vaginal microecological balance are clearly insufficient. The incidence of postpartum BV (31.36%) was higher than that of the first trimester, the incidence of BV in postpartum women was higher, the difference was statistically significant (P <0.05). Three hundred patients were placed in the vagina vaginal live viable capsules, the results showed that the study group vagina p H decreased significantly, close to the normal female vaginal p H level (P lt; 0.05), and the number of vaginal Lactobacilli increased significantly (P lt; 0.05) The incidence of vaginitis at 3 months and 6 months postpartum was significantly lower than that of the control group (P <0.05). Conclusions The amount of vaginal lactobacilli in postpartum women is decreased, and the proportion of the flora is obviously imbalanced. Vaginal inflammation to non-specific vaginitis-based, bacterial vaginosis, fungal vaginitis and trichomonas vaginitis less common. Lactobacillus capsules as ecological treatment of live bacteria preparations, both prevention and treatment of vaginal infections, no adverse reactions, but also can reduce the recurrence rate of postpartum women vaginitis, worthy of clinical application.