本文關(guān)鍵詞：不同陰道灌洗方案對婦科良性腫瘤患者陰道微生態(tài)和舒適度的影響　出處：《河北醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 陰道灌洗 陰道微生態(tài) 菌群密度 陰道pH值 舒適度

【摘要】：目的:觀察不同陰道灌洗方案對患者陰道微生態(tài)和舒適度的影響,尋求最佳陰道灌洗方案,為臨床護理工作提供理論依據(jù)。方法:選取2015年12月至2016年10月在河北省某三甲綜合醫(yī)院婦科180例良性腫瘤住院患者為研究對象,利用電腦EXCEL隨機函數(shù)進行分組,隨機分為試驗一組,試驗二組,試驗三組,試驗四組,試驗五組,試驗六組。在患者入院后,未做任何陰道檢查前,取患者陰道分泌物,選取陰道菌群密度為Ⅲ-Ⅵ度的患者給予不同陰道灌洗方案進行陰道灌洗。采用兩種陰道灌洗方式和灌洗液苯扎氯銨三種不同濃度組成六種陰道灌洗方案。兩種陰道灌洗方式是:方式一:首先沖洗外陰,然后用左手分開小陰唇,將灌洗頭沿陰道側(cè)壁的方向緩慢插入陰道達陰道后穹隆,邊沖洗邊將灌洗頭圍繞子宮頸輕輕地上下左右移動;方式二:首先沖洗外陰,然后用左手分開小陰唇,用窺陰器暴露宮頸后灌洗頭再插入陰道進行沖洗,邊沖洗邊左右旋轉(zhuǎn)窺陰器。苯扎氯銨的三種不同陰道灌洗濃度分別為:0.02%;0.035%;0.05%。在灌洗前和灌洗后24小時分別取患者陰道分泌物進行菌群密度和pH值的檢測。觀察六組患者陰道灌洗前和灌洗后24小時的陰道菌群密度和pH值的變化以及灌洗過程中患者的舒適度。采用格蘭染色法檢測患者陰道分泌物,觀察菌群密度。用pH精密試紙(上海三愛思試劑有限公司)檢測患者陰道pH值。依據(jù)視覺模擬評分法(Visual Analogue Scale,VAS量表),評價患者的舒適度。將六組患者陰道灌洗前和灌洗后24小時的各項數(shù)據(jù)進行組內(nèi)和組間的比較,舒適度進行組間比較。探討六種不同的陰道灌洗方案對陰道菌群密度和pH值以及灌洗過程中患者舒適度的影響。采用SPSS19.0統(tǒng)計軟件進行數(shù)據(jù)分析。結(jié)果:1六組患者基本特征六組患者在年齡(P=0.905)、陰道清潔度(P=0.991)等方面無統(tǒng)計學(xué)差異。2六組患者陰道灌洗前及灌洗后24小時陰道菌群密度的組內(nèi)比較試驗一組患者陰道菌群密度(P0.001),試驗二組患者陰道菌群密度(P0.001),試驗三組患者陰道菌群密度(P0.001),試驗四組患者陰道菌群密度(P=0.001),試驗五組患者陰道菌群密度(P=0.001),試驗六組患者陰道菌群密度(P0.001),均有統(tǒng)計學(xué)差異。3六組患者陰道灌洗前及灌洗后24小時陰道菌群密度的組間比較陰道灌洗前,六組患者陰道菌群密度的組間比較(P=0.670)無統(tǒng)計學(xué)差異,陰道灌洗后24小時陰道菌群密度的組間比較(P=0.294)無統(tǒng)計學(xué)差異。4六組患者陰道灌洗前及灌洗后24小時陰道pH值的組內(nèi)比較試驗一組患者陰道pH值(P=0.066),試驗二組患者陰道pH值(P=0.117),試驗三組患者陰道pH值(P=0.211),試驗四組患者陰道pH值(P=0.088),試驗五組患者陰道pH值(P=0.150),試驗六組患者陰道pH值(P=0.142),均無統(tǒng)計學(xué)差異。5六組患者中陰道灌洗前陰道pH值在3.8-4.5的患者陰道灌洗前及灌洗后24小時陰道pH值的組間比較陰道灌洗前,六組患者的陰道pH值的組間比較(P=0.782);陰道灌洗后24小時,六組患者陰道pH值的組間比較(P=0.456),均無統(tǒng)計學(xué)差異6六組患者陰道灌洗舒適度的組間比較6.1試驗一組、試驗三組、試驗五組患者陰道灌洗舒適度的組間比較試驗一組和試驗三組(P=0.822),試驗一組和試驗五組(P=1.000),試驗三組和試驗五組(P=0.822),均無統(tǒng)計學(xué)差異。6.2試驗二組、試驗四組、試驗六組患者陰道灌洗舒適度的組間比較試驗二組和試驗四組(P=0.261),試驗二組和試驗六組(P=0.339),試驗四組和試驗六組(P=0.866),均無統(tǒng)計學(xué)差異。6.3試驗一組與試驗二組、試驗四組、試驗六組患者陰道灌洗舒適度的組間比較試驗一組和試驗二組(P=0.001),試驗一組和試驗四組(P=0.019),試驗一組和試驗六組(P=0.012),均有統(tǒng)計學(xué)差異。6.4試驗三組與試驗二組、試驗四組、試驗六組患者陰道灌洗舒適度的組間比較試驗三組和試驗二組(P0.001),試驗三組和試驗四組(P=0.010),試驗三組和試驗六組(P=0.006),均有統(tǒng)計學(xué)差異。6.5試驗五組與試驗二組、試驗四組、試驗六組患者陰道灌洗舒適度的組間比較試驗五組和試驗二組(P=0.001),試驗五組和試驗四組(P=0.019)試驗五組和試驗六組(P=0.012),均有統(tǒng)計學(xué)差異。6.6試驗二組與試驗一組、試驗三組、試驗五組患者陰道灌洗舒適度的組間比較試驗二組和試驗一組(P=0.001),試驗二組和試驗三組(P0.001),試驗二組和試驗五組(P=0.001),均有統(tǒng)計學(xué)差異。6.7試驗四組與試驗一組、試驗三組、試驗五組患者陰道灌洗舒適度的組間比較試驗四組和試驗一組(P=0.019),試驗四組和試驗三組(P=0.010),試驗四組和試驗五組(P=0.019),均有統(tǒng)計學(xué)差異。6.8試驗六組與試驗一組、試驗三組、試驗五組患者陰道灌洗舒適度的組間比較試驗六組和試驗一組(P=0.012),試驗六組和試驗三組(P=0.006),試驗六組和試驗五組(P=0.012),均有統(tǒng)計學(xué)差異。結(jié)論:陰道灌洗可以使陰道菌群密度減小,改變陰道微生態(tài)環(huán)境。兩種陰道灌洗方式對陰道菌群密度和pH值的影響無差異。不同濃度的苯扎氯銨溶液對陰道菌群密度和pH值的影響也無差異。苯扎氯銨是一種安全、刺激性小的消毒液。舒適度比較中,不使用窺陰器打開陰道暴露宮頸,直接使用一次性灌洗頭進行陰道灌洗時,病人感覺更舒適。從病人舒適的角度出發(fā),建議直接使用一次性灌洗頭進行陰道灌洗,提高病人的依從性和護士的工作效率。
[Abstract]:Objective: To observe the effect of vaginal lavage on patients with vaginal micro ecological effects of scheme and comfort, to seek the best vaginal lavage and provide a theoretical basis for the scheme, clinical nursing. Methods: from December 2015 to October 2016 in a general hospital of Department of gynaecology in Hebei Province in 180 cases of benign tumor patients as the research object, using the computer random function of EXCEL group. Were randomly divided into experimental group, experimental group two, experimental group three, experimental group four, experimental group five, experimental group. In six patients after admission, did not do any vaginal examination before taking vaginal secretions, selection of vaginal flora density III - VI of patients treated with different vaginal lavage for vaginal lavage solution two. The vaginal lavage lavage fluid and benzalkonium chloride concentration of three different composition of six types of vaginal lavage scheme. Two kinds of vaginal lavage way: one way: first wash the vulva, and then use the The left hand from the labia minora, the irrigation head along the direction of the vaginal wall slowly inserted into the vagina of the vaginal vault, while washing side of the irrigation head around the cervix gently move up and down; two ways: first wash the vulva, and then use the left hand from the labia minora, with vaginal cervical irrigation head again after exposure were inserted into the vagina flushing, edge flush edge rotation around the speculum. The three different vaginal lavage concentrations of benzalkonium chloride respectively: 0.02%; 0.035%; 0.05%. in the lavage before and after lavage for 24 hours were collected from vaginal secretions of patients with bacteria density and pH values of the samples were observed for 24 hours. The vaginal flora density and pH value six groups of patients with vaginal lavage before and after lavage and lavage in comfort. The Glenn staining method to detect vaginal secretions, observe the bacterial density. With pH precision test paper (Shanghai san'aisi Reagent Co., Ltd) detection Patients with vaginal pH value. According to the visual analogue scale (Visual Analogue Scale, VAS), to evaluate the comfort of patients. The six groups of patients before and after vaginal lavage lavage the data 24 hours were compared between and within groups, were compared between the two groups of patients with comfort. Six different vaginal lavage scheme on vagina flora density and pH value in the process of comfort and lavage effect. Data were analyzed by SPSS19.0 statistical software. Results: the 1 basic characteristics of six groups of patients in the six groups in age (P=0.905), vaginal cleanliness test (P=0.991) is a group of patients with vaginal flora density 24 hours of vaginal bacteria the population density within the group, no significant difference between the.2 six groups of patients with vaginal lavage before and after lavage (P0.001) test, two groups of patients with vaginal flora density (P0.001) test, three groups of patients with vaginal flora density (P0.001) test, four groups of patients with vaginal flora Density (P=0.001) test, five groups of patients with vaginal flora density (P=0.001) test, six groups of patients with vaginal flora density (P0.001), there were statistically significant differences between the six groups of.3 patients with vaginal lavage before and after lavage 24 hours of vaginal flora density between the two groups before vaginal lavage, six groups of patients with vaginal flora density the comparison between the two groups had no statistical difference (P=0.670), vaginal lavage 24 hours after vaginal flora density between the two groups (P=0.294) 24 hour vaginal pH value had no significant difference in six groups of.4 patients with vaginal lavage before and after lavage group comparison test of a group of patients with vaginal pH value (P=0.066), test group two. Patients with vaginal pH value (P=0.117) test, three groups of patients with vaginal pH value (P=0.211) test, four groups of patients with vaginal pH value (P=0.088) test, five groups of patients with vaginal pH value (P=0.150) test, six groups of patients with vaginal pH value (P=0.142), there was no significant difference in six groups of.5 patients before vaginal lavage Yin PH value in 24 hours of vaginal vaginal pH value in patients with vaginal lavage 3.8-4.5 before and after lavage lavage group, compared six groups of patients with vaginal pH value between groups (P=0.782); 24 hours after vaginal lavage, compared six groups of patients with vaginal pH group (P=0.456), there was no statistical learn the difference between the 6 groups of patients with vaginal lavage six comfort groups 6.1 test group, test group three, test group five patients with vaginal lavage comfort comparison between groups of test group and test group three (P=0.822), a test group and test group five (P=1.000), test group three and test group five (P=0.822,.6.2) were no significant difference between the test group two, test group four and test group six patients with vaginal lavage comfort comparison between groups of test group two and test group four (P=0.261), test group two and test group six (P=0.339), test group four and test group six (P=0.866), there were no the statistical differences between the.6.3 group and a test The test group two, test group four and test group six patients with vaginal lavage comfort comparison between groups of test group and test group two (P=0.001), a test group and test group four (P=0.019), a test group and test group six (P=0.012), there were statistically significant differences between the.6.4 test group three and test group two four, the test group, the test group six patients with vaginal lavage comfort comparison between groups of test group three and test group two (P0.001), test group three and test group four (P=0.010), test group three and test group six (P=0.006), there were statistically significant differences between the.6.5 test group five and test group two, test the four test group, six groups of patients with vaginal lavage comfort comparison between groups of test group five and test group two (P=0.001), test group five and test group four (P=0.019) test group five and test group six (P=0.012), there were statistically significant differences between the.6.6 test group two and test group, test group three, test five groups of patients with vaginal lavage The comfort of comparison between groups of test group two and test group (P=0.001), test group two and test group three (P0.001), test group two and test group five (P=0.001), there were statistically significant differences between the.6.7 test group four and test group, test group three and test group five patients with vaginal lavage comfort comparison between groups of test group four and test group (P=0.019), test group four and test group three (P=0.010), test group four and test group five (P=0.019), there were statistically significant differences between the.6.8 test group six and test group, test group three and test group five patients with vaginal lavage comfort between the two groups the test group six and test group (P=0.012), test group six and test group three (P=0.006), test group six and test group five (P=0.012), there was significant difference. Conclusion: vaginal lavage can make the vaginal flora density decreased, change vaginal microecological environment. Two kinds of vaginal bacterial vaginal lavage the population density and pH No difference in value. There was no difference in the effect of different concentrations of Benzalkonium Chloride Solution on vagina flora density and pH value. Benzalkonium chloride is a safe and stimulating disinfectant small comfort. In comparison, do not use vaginal speculum open exposure cervix, direct use of disposable lavage head for vaginal lavage, the patient feels more comfortable. Starting from the comfort of the patient, it is recommended to use disposable lavage head for vaginal lavage, improve patient compliance and the work efficiency of nurses.

【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R473.73

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