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[1]姚 祺,黄美霞,闵羡蕙,等.子宫切除术宫颈去留对阴道微生态的影响[J].医学研究与战创伤救治(原医学研究生学报),2015,17(03):246-249.[doi:10.3969/j.issn.1672-271X.2015.03.007]
　YAO Qi,HUANG Mei-xia,MIN Xian-hui,et al.The impacts of maintain or remove of cervixl in hysterectomy on vaginal microecosystem[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2015,17(03):246-249.[doi:10.3969/j.issn.1672-271X.2015.03.007]
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子宫切除术宫颈去留对阴道微生态的影响()
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《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第17卷
期数:
2015年03期
页码:
246-249
栏目:
出版日期:
2015-05-20

文章信息/Info

Title:
The impacts of maintain or remove of cervixl in hysterectomy on vaginal microecosystem
作者:
姚 祺; 黄美霞; 闵羡蕙; 李一妹
351100 福建莆田，南京军区福州总医院95临床部妇产科
Author(s):
YAO Qi;  HUANG Mei-xia;  MIN Xian-hui;  LI Yi-mei.
Department of Gynecology and Obstetrics， 95 Clinical Branch， Fuzhou General Hospital of Nanjing Military Command， Putian， Fujian 351100, China
关键词:
子宫切除;  宫颈去留; 阴道微生态 ; 辅助性T 细胞17
Keywords:
hysterectomy;  maintain or remove of cervixl;  vaginal microecosystem;  Th17
分类号:
R713.42
DOI:
10.3969/j.issn.1672-271X.2015.03.007
文献标志码:
A
摘要:
目的 分析不同子宫切除术对阴道微生态的影响，探讨不同术式对阴道免疫功能的影响。方法 将300例微生态评价正常的子宫疾病患者，按手术方式分为全子宫切除组（100例）、次全子宫切除组（100例）及非子宫切除组（100例）。对三组患者术后阴道微生态系统进行再评价及对比，同时观察三组外周血清T细胞17（Th17）的变化情况。结果 ①三组患者阴道微生态系统均产生不良变化（菌群密集度及多样性），其中全子宫切除组表现较为明显（P<0.05），非子宫切除组影响程度最小；②非子宫切除中以乳酸杆菌计数为优势菌病例占93%，次全子宫切除及全子宫切除组分别为89%及60%；三组乳酸杆菌比例差异具有统计学意义（P<0.05）；③全子宫切除术组和次全子宫切除组病原菌检出率无明显差异，但与子宫非切除术组之间差异具有统计学意义（P<0.05）；④全子宫切除组阴道分泌物标本涂片革兰染色Nugent评分明显高于次全子宫切除组及非子宫切除术组，三组比较具有统计学差异（P<0.05）；⑤全子宫切除组术后阴道pH≤4.5患者比例明显高于其他两组，差异有统计学意义（P<0.05）；⑥全子宫切除组阴道微生态功能正常为40%，次全子宫切除组为71%，非子宫切除术组为91%，三组结果统计有统计学意义（ P<0.05）；⑦非子宫切除术组辅助性Th17百分率低于两组子宫切除组（P＜0.01），其中全子宫切除术组升高最明显。结论 全子宫切除术对阴道微生态的影响较次子宫切除、非子宫切除明显，其可能与阴道免疫防御功能降低有关。
Abstract:
Objective To analyze the impacts of different hysterectomy on vaginal microecosystem， simultaneously discuss the influences of different operative methods on vaginal immune function. Methods 300 cases of normal microecological evaluation of hysterectomy patients in our hospital were included into the study， divided into panhysterectomy group (100 cases)， subtotal hysterectomy group (100 cases) and the hysterectomy group (100 cases)， according to the hysterectomy methods， reassessed and compared postoperative vaginal microecosystem of the three groups of patients， and observed the changes of Th17 cells in peripheral serum of the three groups. Results ①The vaginal microecosystem in three groups of patients generated disturbing changes， the changes on intensity and diversity of vaginal flora in the vaginal microecosystem of panhysterectomy group were most significant than the other groups (P<0.05)； ②The gram-positive big bacillus were the dominant bacteria in the vaginal bacteria of the three groups， then was gram-positive coccus， the quantity of gram-positive big bacillus of the panhysterectomy group were significantly more than he other groups (P<0.05)(P<0.05)； ③The pathogen distribution differences of postoperative candida and trichomonas vaginalis in the three groups were with statistical significance (P<0.05)； ④Vaginal smear gram staining Nugent scores of specimens in the patients with panhysterectomy were significantly higher than he other groups with significant differences (P<0.05)； ⑤The proportion of the postoperative patients with vaginal pH≤4.5 in the subtotal hysterectomy group was obviously inferior to the patients with panhysterectomy， with statistically significant differences (P<0.05)； ⑥The vaginal microecological function of the panhysterectomy group was 40%， that of subtotal hysterectomy group was 71%， the results of the three groups were with statistical significant differences (P<0.05)； ⑦Flow cytometry detection were used to detect CD4+IL-17+ in different groups of vaginal secretions， percentage of CD4+IL-17+ cell in the subtotal hysterectomy group was significantly inferior to (P<0.01) of panhysterectomy group. Conclusion The impacts of panhysterectomy on vaginal microecosystem is more obvious than hysterectomy， it may be associated with the decrease of vaginal immune defense function.

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更新日期/Last Update: 2015-05-20