本文選題：需氧菌陰道炎　切入點：混合感染　出處：《山西醫(yī)科大學》2017年碩士論文　論文類型：學位論文

【摘要】：目的:探討需氧菌陰道炎(Aerobic Vaginitis,AV)的臨床特征及其影響因素,為AV的臨床診治提供依據(jù)。方法:選取2016年4月-2016年12月在山西醫(yī)科大學第一醫(yī)院、臨汾市人民醫(yī)院、晉煤大醫(yī)院婦科門診就診的516例AV患者為研究對象。對陰道分泌物行細菌培養(yǎng),統(tǒng)計AV的感染狀況,并記錄AV的臨床特征及分析其可能的影響因素。結(jié)果:(1)在516例患者中,年齡20歲者有30例(5.81%,30/516),21-30歲者有201例(38.95%,201/516),31-40歲者156例(30.23%,156/516),41-50歲者75例(14.53%,75/516),51-60歲者33例(6.39%,33/516),60歲者21例(4.07%,21/516);(2)516例共有508例培養(yǎng)出細菌,8例未培養(yǎng)出細菌,其中一種致病原為487例,多種致病原21例。單一病原中居前三位的是大腸桿菌166例(34.1%)、金黃色葡萄球菌111例(22.8%)和β溶血性鏈球菌75例(15.4%),而混合菌種中主要為大腸桿菌+金黃色葡萄球菌9例;(3)AV單一感染327例,占比63.4%,AV混合感染189例,占比36.6%;(4)AV單一感染和混合感染在外陰瘙癢(（？）=1.99,P=0.16)、白帶異常(（？）=0.90,P=0.34)方面比較差異無統(tǒng)計學意義,而單一感染和混合感染在灼痛(（？）=44.01,P0.01)、黏膜充血(（？）=77.45,P0.01)、清潔度(（？）=26.63,P0.01)、乳酸桿菌(（？）=77.49,P0.01)及陰道分泌物PH值(（？）=38.15,P0.01)有關(guān);(5)AV混合感染與年齡(（？）=21.82,P0.01)、教育程度(（？）=24.25,P0.01)、經(jīng)常出差(（？）=30.91,P0.01)、性伴侶個數(shù)(（？）=8.39,P0.01)、性生活史(（？）=8.39,P0.01)及安全套避孕(（？）=9.29,P0.01)相關(guān),而與吸煙(（？）=1.29,P=0.25)、飲酒(（？）=1.18,P=0.28)及陰道沖洗習慣(（？）=0.31,P=0.58)無明顯相關(guān)性。結(jié)論:(1)在AV患者中,育齡期婦女多見;(2)AV感染可由一種或多種需氧菌致病,最常見致病菌為大腸桿菌;(3)AV混合感染常見,其中與細菌性陰道病(Bacterial vaginosis,BV)混合多見;(4)AV混合感染患者更多表現(xiàn)為陰道灼痛、黏膜充血、乳酸桿菌少、清潔度差及PH偏高;(5)AV混合感染與年齡、教育程度、經(jīng)常出差、性伴侶個數(shù)、性生活史及避孕套避孕相關(guān),而與吸煙、飲酒及陰道沖洗習慣無明顯相關(guān)性。
[Abstract]:Objective: to investigate the clinical characteristics and influencing factors of Aerobic VaginitisAV (AVV) in order to provide the basis for clinical diagnosis and treatment of AV. Methods: select the first Hospital of Shanxi Medical University from April 2016 to December 2016, Linfen people's Hospital. 516 cases of AV patients in gynecological outpatient clinic of Shanxi Coal University Hospital were studied. The bacterial culture of vaginal secretions was carried out, the infection status of AV was recorded, and the clinical characteristics of AV were recorded and the possible influencing factors were analyzed. There were 30 people of 20 years of age, 30 / 516 / 21-30 years old, 201 cases with 38.95 / 201516 / 40 years old, 156 cases with 30.23 156 / 516 / 50 years old, 75 cases with 14.53 / 51651-60 years old, 33 cases with 6.393333 / 516% / 60 year old, 21 cases with 6.393333516 / 60 year old 21 / 21 516 / 2516 cases with a total of 508 cases of uncultured bacteria, of which there were 487 cases of uncultured bacteria. Among the 21 cases of multiple pathogens, 166 cases of Escherichia coli were in the top 3, 111 cases of Staphylococcus aureus were 22. 8%) and 75 cases of 尾 -hemolytic streptococcus were 15. 4%, while 9 cases of mixed bacteria were Escherichia coli Staphylococcus aureus. There were 327 cases of single infection of AV. There were 189 cases of mixed infection of AV in 63.4%, 36.6% of single infection of AV and mixed infection of AV in vulva pruritus? Is 1. 99 Pu 0.16??? There was no statistical difference between 0.90 and 0.34), but single infection and mixed infection had no statistical significance. 44.01U P0.01A, mucosal congestion? P0.01C, 77.45m, cleanliness? P0.01A 26.63%, Lactobacillus lactis? P0.01) and the PH value of vaginal secretion? AV mixed infection and age? 21. 82% P0. 01, educational level? Do you often travel on business? Do you have 30.91U P0.01a, and how many sexual partners do you have? Do you have a life history of 8. 39% P0. 01? P0.01) and condom contraception??? (P 0.01), but related to smoking? Do you have 1. 29??? (1. 18 / 0. 28) and vaginal washing habits? Conclusion: in patients with AV, AV infection is more common in women of childbearing age than that in women of childbearing age. AV infection can be caused by one or more aerobic bacteria, and the most common pathogenic bacteria is Escherichia coli. Among them, patients mixed with bacterial vaginosism (BV) were more likely to have vaginal burns, congestion of mucous membrane, less lactobacillus, poor cleanliness and high PH, mixed infection with age, education, frequent travel, and number of sexual partners. Sexual history and condom contraception were not correlated with smoking, drinking and vaginal washing.
【學位授予單位】：山西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R711.31

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