宫颈炎患者微生物学检验联合阴道分泌物标本五联检验的价值分析

摘要/Abstract

摘要： 目的探讨与分析宫颈炎患者微生物学检验联合阴道分泌物标本五联检验的价值,以促进宫颈炎的早期检出。方法选择2020年1月—2022年7月在北京中医医院顺义医院诊治的78例宫颈炎患者作为研究对象,所有患者均给予微生物学检验联合阴道分泌物标本五联检验并进行评分分析,同时给予组织病理学检查并判断诊断价值。结果在78例患者中,微生物学检验联合阴道分泌物标本五联检验判断为CINⅠ级者32例,CINⅡ级28例者,CIN Ⅲ级者10例,宫颈癌者8例。病理诊断为CINⅠ级者33例,CINⅡ级者24例,CINⅢ级者11例,宫颈癌者10例。微生物学检验联合阴道分泌物标本五联检验诊断CINⅠ、CINⅡ、CINⅢ、宫颈癌的准确率分别为96.97%（32/33）、82.14%（23/28）、70.00%（7/10）、100.00%（8/8）,总诊断准确率为89.74%（70/78）,出现错误诊断8例。Spearsman分析显示初潮年龄、吸烟、血糖、孕次、产次与微生物学检验联合阴道分泌物标本五联检验错误诊断率存在相关性（P<0.05）。多因素回归logistic分析显示初潮年龄、吸烟、血糖、孕次、产次均为导致微生物学检验联合阴道分泌物标本五联检验错误诊断率发生的主要独立危险因素（P<0.05）。结论微生物学检验联合阴道分泌物标本五联检验有助于临床医师早期判断宫颈炎患者的病情状况,但是也存在一定的错误诊断情况,初潮年龄、吸烟、血糖、孕次、产次为导致错误诊断发生的重要原因。

关键词: 微生物学检验, 阴道分泌物, 五联检验, 宫颈炎, 初潮年龄, 多因素分析

Abstract: Objective To explore and analysis the values of microbiological examination combined with penta test of vaginal secretion specimens in patients with cervicitis, so as to promote the early detection of cervicitis. Methods From January 2020 to July 2022, 78 cases of patients with cervicitis who were diagnosed and treated in our hospital were selected as the research subjects. All patients were given microbiological examination combined with vaginal secretion specimen quintuple examination. At the same time, histopathological examination was given and the diagnostic value was judged. Results In the 78 patients, there were 32 cases were classified as CIN grade Ⅰ, 28 cases of CIN gradeⅡ, 10 cases of CIN gradeⅢ, and 8 cases of cervical cancer by microbiological examination combined with vaginal secretion specimen quintuple examination. The pathological diagnosis was CIN gradeⅠ in 33 cases, CIN gradeⅡ in 24 cases, CIN gradeⅢ in 11 cases, and cervical cancer in 10 cases. The accuracy rates of microbiological examination combined with vaginal secretion specimen quintuple examination in diagnosing CIN gradeⅠ, CIN gradeⅡ, CIN gradeⅢ and cervical cancer were 96.97%(32/33), 82.14%(23/28), 70.00%(7/10), 100.00%(8/8). The total diagnostic accuracy rate was 89.74%(70/78), and there were 8 cases were error diagnosis. Spearsman analysis showed that age at menarche, smoking, blood sugar, pregnancy, parity were correlated to the error diagnosis (P<0.05). Multivariate logistic regression analysis showed that age at menarche, smoking, blood sugar, pregnancy and parity were the main independent risk factors for the error diagnosis of microbiological examination combined with vaginal secretion specimen quintuple examination (P<0.05). Conclusion Microbiological examination combined with vaginal secretion specimen quintuple examination can help clinicians to judge the condition of patients with cervicitis early, but there are also some error diagnosis. Menarche, smoking, blood sugar, pregnancy and parity were the important reasons for error diagnosis.

Key words: microbiological test, vaginal secretions, quintuplex test, cervicitis, age at menarche, multivariate analysis

中图分类号:

R446

孟思彤. 宫颈炎患者微生物学检验联合阴道分泌物标本五联检验的价值分析[J]. 中华养生保健, 2023, 41(4): 18-22.

MENG Si-tong. Analysis of the Value of Microbiological Examination Combined with Vaginal Secretion Specimen Quintuple Examination in Patients with Cervicitis[J]. ZHONGHUA YANGSHENG BAOJIAN, 2023, 41(4): 18-22.

参考文献

[1] 卿荣珍,黄川雨,刘新月,等.壮医药线灸治疗慢性宫颈炎合并人乳头瘤病毒感染疗效观察[J].上海针灸杂志,2022,41(4):376-380.
[2] 李秀青,钱李燕,马锦莲.不同人口学与婚育特征的育龄期女性下生殖道感染因素及预防知识调查[J].中国妇幼保健,2022,37(14):2644-2647.
[3] 李淑华,杨焱,余受益.妇科排毒汤联合西药治疗慢性宫颈炎合并HPV感染的疗效及对病毒载量的影响[J].世界中西医结合杂志,2021,16(7):1279-1283.
[4] 常玉梅,张凤喜,王薇,等.复方沙棘籽油栓联合重组人干扰素α2b凝胶治疗慢性宫颈炎合并高危型人乳头瘤病毒感染疗效观察[J].河北中医,2021,43(6):969-971,991.
[5] MWALIKO E, VAN HAL G, BASTIAENS H, et al.Early detection of cervical cancer in western Kenya: determinants of healthcare providers performing a gynaecological examination for abnormal vaginal discharge or bleeding[J]. BMC Fam Pract,2021,22(1):52.
[6] 张兰,温路生,陈婧,等.富血小板血浆对大鼠宫颈糜烂的治疗作用及其对炎性因子表达的影响[J].重庆医学,2021,50(2):188-192.
[7] 赵阅,张丽,任青玲.加味二妙颗粒联合干扰素调节宫颈阴道微生态清除HR-HPV感染临床研究[J].时珍国医国药,2021,32(4):896-899.
[8] 林楚娟,卿荣珍.壮医药线点灸治疗慢性子宫颈炎合并人乳头瘤病毒感染[J].河南中医,2021,41(9):1408-1411.
[9] 刘翠萍,张颖,李宁莉.干扰素联合红外线局部照射治疗人乳头瘤病毒及相关阴道炎和宫颈炎大鼠的作用及相关机制研究[J].临床和实验医学杂志,2021,20(13):1353-1357.
[10] 王宁宁,赵宇,张丁丹,等.二十五味鬼臼丸联合重组人干扰素α2a栓治疗慢性宫颈炎的临床研究[J].现代药物与临床,2021,36(6): 1277-1280.
[11] 黄翠敏,孔令婉,窦倩如,等.海南省妇女生殖健康筛查结果分析[J].中国热带医学,2019,19(1):81-84.
[12] 陆晓红,季静,曹忍忍.保妇康联合冷冻治疗对宫颈炎患者细胞免疫功能及临床疗效的影响[J].实用临床医药杂志,2019,23(12):39-41,44.
[13] 陈值亲. 苦参止带汤熏洗联合达克宁栓治疗复发性霉菌性阴道炎88例[J].中国中医药科技,2019,26(2):295-296.
[14] 黄湘,傅广华.子宫颈炎症对宫颈上皮内瘤样变患者疾病转归的影响[J].国际病毒学杂志,2018,25(4):267-270.
[15] 郭冰杰,杨彩梅.宫颈癌患者人乳头状瘤病毒感染与阴道细菌感染的相关性[J].西部医学,2018,30(5):660-663,667.
[16] 吴向晖,黄鹏翀,熊丽丽,等.宫颈上皮内瘤变程度相关危险因素研究[J].实用预防医学,2018,25(4):486-489.
[17] 何惠,秦薇,曹明月,等.宫颈癌患者生殖道细菌感染及人乳头瘤病毒感染情况分析[J].中华医院感染学杂志,2017,27(2):408-410.
[18] 季丽,樊秀清,姚淑霞,等.山东省聊城市东昌府区农村妇女宫颈癌筛查结果分析[J].华南预防医学,2017,43(4):350-352.
[19] 蔡春苗,符爱贞,翁叶蕊.妊娠晚期孕妇高危型HPV感染及危险因素分析[J].中国计划生育学杂志,2021,29(9):1804-1807.
[20] XU Y, WU H, HUANG C, et al.Clinical value of traditional laparotomy, extensive vaginal hysterectomy, and laparoscope-assisted vaginal hysterectomy in the treatment of patients with cervical intraepithelial neoplasia Ⅲ[J]. Transl Cancer Res,2021,10(5):2409-2415.