發(fā)布時間：2018-03-14 15:36

  本文選題：單一陰道炎　切入點：混合性陰道炎　出處：《山西醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:了解門診女性下生殖道感染類型的構(gòu)成情況,進(jìn)而了解混合性陰道炎和混合宮頸炎的比例。探討陰道混合感染同時針對性用藥與臨床逐一治療的臨床效果比較。方法:選取2015-12到2016-12山西大醫(yī)院婦科門診經(jīng)臨床表現(xiàn)和實驗室檢查確診的825例下生殖道感染患者為研究對象。對其年齡、月經(jīng)情況、就診原因等一般資料進(jìn)行收集,并對每例患者常規(guī)行婦科檢查,觀察白帶的量、顏色和性狀,宮頸口周圍是否有炎性分泌物分布。兩根棉拭子均蘸取陰道側(cè)壁上1/3的分泌物,一份用于陰道pH檢測,另一份用于實驗室檢查(鹽水濕片及革蘭染色檢查),觀察內(nèi)容包括白細(xì)胞數(shù)量、上皮細(xì)胞、有無滴蟲、線索細(xì)胞、孢子、菌絲、乳桿菌,陰道菌群及陰道清潔度的測定。本課題研究我院婦科門診825例下生殖道感染類型的構(gòu)成情況及混合感染的比例。對混合性陰道炎患者(BV+VVC、AV+BV),采用同時針對性治療與模擬臨床上逐一治療對照,比較兩種治療的有效率。結(jié)果:1.825例下生殖道感染中,單一陰道炎占59.03%(487/825),混合感染占40.97%(338/825)。2.單一陰道炎以BV居多,197例(40.45%),其次是VVC 143例(29.36%),再者是AV 101例(20.74%),TV 43例(8.83%),CV最少,3例(0.62%)。3.下生殖道混合感染中,最常見的混合類型是BV+VVC,93例(27.51%),其次是BV+AV 86例(25.44%),再者依次是VVC+AV 34例(10.06%)、BV+TV 32例(9.47%)、AV+TV 30例(8.88%)、BV+TV+AV 27例(7.99%)、AV+BV+VVC 15例(4.44%),BV+VVC+TV最少,8例(2.37%)�；旌蠈m頸炎13例(3.85%)。4.BV+VVC感染的90例患者,隨機分為對照組45例(氟康唑0.15g,第1、4天兩日療法)和研究組45例(氟康唑0.15g,第1、4天兩日療法+甲硝唑陰道泡騰片0.4g/晚×7天)。兩種方法治療BV+VVC有效率比較差異有統(tǒng)計學(xué)意義(P0.05)。即氟康唑+甲硝唑陰道泡騰片聯(lián)合治療的有效率(95.56%)高于單用氟康唑(71.11%)。5.AV+BV感染的80例患者,隨機分為對照組40例(甲硝唑片0.4g 2次/日×7天)和研究組40例(甲硝唑片0.4g 2次/日×7天+克林霉素磷酸酯陰道凝膠1支/晚(5g)×6天)。兩種方法治療AV+BV有效率比較差異有統(tǒng)計學(xué)意義(P0.05)。即甲硝唑+克林霉素磷酸酯陰道凝膠聯(lián)合治療的有效率(95.0%)高于單用甲硝唑(52.5%)。結(jié)論:1.下生殖道感染中混合性感染占較高比例(包括宮頸炎),臨床診斷應(yīng)全面準(zhǔn)確。2.下生殖道混合感染,進(jìn)行同時針對性治療優(yōu)于逐一治療。
[Abstract]:Objective: to investigate the types of lower genital tract infection in outpatients. In order to understand the proportion of mixed vaginitis and mixed cervicitis, to explore the clinical effects of combined vaginal infection and clinical treatment. Methods: select 2015-12 to 2016-12 Shanxi Hospital gynecological outpatient clinic clinical results. The age of 825 patients with lower genital tract infection confirmed by clinical manifestation and laboratory examination was studied. General data such as menstruation, reasons for seeing a doctor and so on were collected, and gynecological examinations were performed on each patient to observe the quantity, color and character of leucorrhea. Whether or not inflammatory secretions are distributed around the cervix. Both cotton swabs are dipped in 1/3 of the vaginal secretions on the lateral wall of the vagina, and one part is used to detect vaginal pH. The other was used for laboratory tests (saline wet tablets and Gram staining) for white blood cell count, epithelial cells, trichomonas, clue cells, spores, hyphae, lactobacillus, Determination of vaginal flora and vaginal cleanliness. This subject is to study the composition of lower genital tract infection type and the proportion of mixed infection in 825 cases of gynecological outpatient in our hospital. The patients with mixed vaginitis were treated with BV VVCU AV BV BVV at the same time. As compared with the simulated clinical treatment one by one, Results in 1. 825 cases of lower genital tract infection, Single vaginitis accounted for 59.03487 / 825, mixed infections 40.97 / 825.2.The single vaginitis were mainly BV in 197 cases, followed by VVC in 14.3 cases, followed by VVC #number0# cases, followed by AV 101 cases with 20.74TV, 43 cases with 8.83ACV, with the least 3 cases with 0.622.3.In the lower genital tract infection, The most common type of mixing was BV VVCV in 93 cases, BV AV in 86 cases, BV AV in 86 cases, and BV in turn, followed by VVC AV in 34 cases, BV TV in 32 cases and BV TV in 30 cases, in which there were 30 cases of BV AV and 30 cases of BV VV, 27 cases of BV VV AV, 27 cases of BV BV VVC, 15 cases of BV BV VVC, 15 cases of BV BV VVC TV, 15 cases of BV AV, 15 cases of BV VVC TV, 15 cases of BV AV, 15 cases of BV AV, 15 cases of BV VVC TV, 15 cases of BV AV, 15 cases of BV VVC TV, 15 cases of BV AV, 15 cases of BV AV, 15 cases of BV VVC TV, 15 cases of BV AV, They were randomly divided into two groups: the control group (n = 45) (fluconazole 0.15g) and the study group (n = 45) (fluconazole 0.15g) and the study group (n = 45). The effective rate of metronidazole vaginal effervescent tablets was 0.4g / night 脳 7d. There was a significant difference between the two methods in the treatment of BV VVC. The effective rate of fluconazole metronidazole vaginal effervescent tablet was 95.56), which was higher than that of 80 patients with BV infection of fluconazole alone 71.110.5.AV BV infection rate was higher than that of fluconazole metronidazole vaginal effervescent tablet alone. They were randomly divided into control group (n = 40) (metronidazole tablet 0.4g / d 脳 7 days) and study group (n = 40) (metronidazole tablet 0.4g / d 脳 7 days) 脳 6 days. The difference was statistically significant (P 0.05). That is, the effective rate of metronidazole clindamycin phosphate vaginal gel was 95.0% higher than that of metronidazole alone 52.5%. Conclusion: 1. Mixed infections (including cervicitis) are higher in lower genital tract infection than in metronidazole alone. Clinical diagnosis should be comprehensive and accurate .2. mixed infection of lower genital tract, Simultaneous targeted therapy is better than one treatment.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R711.3

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 周一帆;王睿;董熙遠(yuǎn);熊婷;章漢旺;;育齡女性下生殖道感染病原體的分布、危險因素及健康教育需求分析[J];中華醫(yī)院感染學(xué)雜志;2017年02期

2 薛鳳霞;王寶晨;王辰;;下生殖道感染診治中面臨的問題與挑戰(zhàn)[J];中國婦產(chǎn)科臨床雜志;2016年06期

3 馬薇;金措;;女性一生不同階段陰道微生態(tài)菌群特征研究進(jìn)展[J];中國實用婦科與產(chǎn)科雜志;2016年08期

4 牛小溪;肖冰冰;王奔;那日蘇;廖秦平;;甲硝唑治療細(xì)菌性陰道病前后陰道菌群的結(jié)構(gòu)變化及其預(yù)后相關(guān)性[J];中國微生態(tài)學(xué)雜志;2016年07期

5 周丹;鄧文慧;李葉;呂秋波;孟慶偉;;外陰陰道假絲酵母菌病患者陰道乳桿菌的功能變化[J];醫(yī)學(xué)研究雜志;2016年02期

6 張瑞;桑佳特;吳文湘;那日蘇;牛小溪;廖秦平;;無癥狀性BV的自然轉(zhuǎn)歸及其高危因素分析[J];現(xiàn)代婦產(chǎn)科進(jìn)展;2015年12期

7 李瑤;;氧氟沙星栓聯(lián)合雌激素治療老年性陰道炎患者的療效和安全性分析[J];現(xiàn)代診斷與治療;2015年21期

8 溫愛萍;;甲硝唑聯(lián)合克林霉素磷酸酯栓治療細(xì)菌性陰道病的臨床療效觀察[J];中國醫(yī)藥指南;2015年28期

9 張瑞芬;朱寶利;;陰道菌群與細(xì)菌性陰道病研究進(jìn)展[J];傳染病信息;2015年04期

10 王姍姍;曾慧琳;符旭東;;雌二醇陰道用制劑的臨床應(yīng)用[J];醫(yī)藥導(dǎo)報;2015年04期

相關(guān)碩士學(xué)位論文 前1條

1 宋世靜;全子宮切除術(shù)后陰道微生態(tài)的狀況分析[D];山西醫(yī)科大學(xué);2015年

，

本文編號：1611836