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[细菌性阴道炎和阴道病的患病率:与临床及实验室特征的关联及治疗]

[Prevalence of bacterial vaginitis and vaginosis: association with clinical and laboratory features, and treatment].

作者信息

Rivera L R, Trenado M Q, Valdez A C, Gonzalez C J

机构信息

Investigadores Asociados.

出版信息

Ginecol Obstet Mex. 1996 Jan;64:26-35.

PMID:8948921
Abstract

This was a cross-sectional study meant to determine the prevalence of vaginitis and bacterial vaginosis among open population females from Cuernavaca City. The relationship between clinical manifestations, laboratory diagnosis and response to therapy were evaluated as well. A group of 405 sexually active women were enrolled between January and July, 1994. The patients were attending the City Hospital for a regular gynecological consultation, upon their informed consent, they answered a specifically designed questionnaire and had a vaginal secretion sampling. Cotton swabs containing such secretions were employed to measure pH, estimate amines production (fishy odor) and perform both direct microscopic examination and Gram stained smears, which allowed the recognition of yeasts, Trichomonas vaginalis, "clue" cells and normal microflora. Treatments were clotrimazole for candidiasis and metronidazole for trichomoniasis and bacterial vaginosis. Data obtained were analyzed with statistical programs SPSS/PC and EGRET. Overall, 193 out of 405 women (47.7%) had some genital infection; most frequent was candidiasis with a prevalence of 105/405 (26%), bacterial vaginosis and trichomoniasis were present in 67/405 (16.5%) and 7/405 (1.7%) of the population, respectively. Clinical features associated to candidiasis were vulvar itching, dyspareunia, vulvar and cervical erythema, cervical inflammation and vaginal secretion. The only sign consistently observed in bacterial vaginosis patients was a yellow secretion. Women with T. vaginalis showed cervical lesions, friability, microhemorragic zones and vaginal secretion. One important factor linked to bacterial vaginosis was to have had premature labor. Therapeutic responses, with clinical and microbiological cure, were 92% for candidiasis; 93% for bacterial vaginosis; and 100% for trichomoniasis. In conclusion, it is of relevance to stimulate sexually active women to care for their genital health to medically diagnose, avoid and control the very common infections assessed in this paper.

摘要

这是一项横断面研究,旨在确定库埃纳瓦卡市开放人群中女性阴道炎和细菌性阴道病的患病率。同时还评估了临床表现、实验室诊断与治疗反应之间的关系。1994年1月至7月,招募了一组405名有性行为的女性。这些患者前往市医院进行常规妇科会诊,在获得她们的知情同意后,她们回答了一份专门设计的问卷,并进行了阴道分泌物采样。用含有此类分泌物的棉拭子测量pH值、评估胺的产生(鱼腥味),并进行直接显微镜检查和革兰氏染色涂片,从而识别酵母菌、阴道毛滴虫、“线索”细胞和正常微生物群。念珠菌病的治疗药物为克霉唑,滴虫病和细菌性阴道病的治疗药物为甲硝唑。使用统计软件SPSS/PC和EGRET对获得的数据进行分析。总体而言,405名女性中有193名(47.7%)患有某种生殖器感染;最常见的是念珠菌病,患病率为105/405(26%),细菌性阴道病和滴虫病分别占人群的67/405(16.5%)和7/405(1.7%)。与念珠菌病相关的临床特征有外阴瘙痒、性交困难、外阴和宫颈红斑、宫颈炎症以及阴道分泌物。在细菌性阴道病患者中始终观察到的唯一体征是黄色分泌物。阴道毛滴虫感染的女性表现为宫颈病变、脆弱、微出血区以及阴道分泌物。与细菌性阴道病相关的一个重要因素是早产。念珠菌病的临床和微生物学治愈率为92%;细菌性阴道病为93%;滴虫病为100%。总之,鼓励有性行为的女性关注其生殖健康,以便对本文中评估的非常常见的感染进行医学诊断、避免和控制,这具有重要意义。

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