Analysis Of 825 Cases Of Lower Genital Tract Infective Types And Study On The Treatment Of Its Mixed Infection

Objective:To understand the composition of the female lower genital tract infective types in outpatients clinics,thus understanding the proportion of mixed vaginitis and mixed cervicitis.And to compare the clinical effect of simultaneously targeted treatment of vaginal mixed infection with respective treatment.Methods:From Dec 2015 to Dec 2016,825 patients diagnosed as lower genital tract infection by clinical manifestations and laboratory examination in gynecological outpatient department of Shanxi DaYi Hospital were enrolled.The general data were collected on the patients,such as age,menstruation situation and chief complaint.The vaginitis were conducted routine examination of gynaecology to observe the amount,color and characteristics of vaginal discharge and to know if there was a distribution of inflammatory secretions around the external cervical orifice.Both cotton swabs took secretions which stood one third of the vaginal wall,one used for vaginal pH test,the other for laboratory tests(the method of salt-solution and gram staining method).The observation items included white blood cells,epithelial cells,trichomoniasis,clue cells,spores,hypha,lactobacillus,and the vaginal cleanliness and vaginal flora.This topic studied the composition of 825 cases of lower genital tract infective types and proportion of mixed infection in the gynecology clinic.For the patients with mixed vaginitis(BV+VVC,AV+BV),the efficacy of the two treatments was compared between the simultaneously targeted therapy and simulated clinical respective treatment.Results:1.Among the 825 cases with lower genital tract infection,single vaginitis cases were found in 59.03%(487/825)and mixed infections were diagnosed in 40.97%(338/825).2.Single vaginitis was mostly,BV 197 cases(40.45%),followed by VVC,143 cases(29.36%),and in addition,there were 101 cases of AV(20.74%),TV in 43 cases(8.83%),CV minimum,3 cases(0.62%).3.In the lower genital tract mixed infection,the most common type of hybrid was BV+ VVC,93 cases(27.51%),the second was BV + AV,86 cases(25.44%),followed by VVC + AV,34 cases(10.06%);BV+ TV,32 cases(9.47%);AV + TV,30 cases(8.88%);BV + TV+AV,27 cases(7.99%);AV + VVC+ BV,15 cases(4.44%)and BV + VVC + TV was the least,only 8 cases(2.37%).There were 13 cases of mixed cervicitis(3.85%).4.Ninety cases of patients with BV + VVC infection were randomly divided into control group in which there were 45 cases(fluconazole 0.15 g in the first day and the fourth day,two days therapy)and research group in which there were 45 cases(fluconazole0.15 g in the first day and the fourth day,two days therapy and metronidazole vaginal effervescent tablets 0.4g before sleep,a total of 7 days).The efficient comparative difference of these two methods to treat BV + VVC was statistically significant(P < 0.05).The effective rate of therapy which was fluconazole + metronidazole vaginal effervescent tablets(95.56%)was higher than only oral fluconazole(71.11%).5.Eighty cases of patients with AV + BV infection were randomly divided into control group with 40 cases(0.4 g metronidazole tablets,two times per day for 7 days)and research group with 40 cases(0.4 g of oral metronidazole twice a day for 7 days + 5 g of clindamycin phosphate vaginal gel,once a day for 6 days).The efficient comparative difference of these two methods to treat AV + BV was statistically significant(P < 0.05).The effective rate of therapy which was metronidazole + clindamycin phosphate vaginal gel(95.0%)was higher than only oral fluconazole(52.5%).Conclusion:1.In the lower genital tract infection,mixed infection accounted for a high proportion(including cervicitis),the clinical diagnosis should be comprehensive and accurate.2.For lower genital tract mixed infection,the simultaneously targeted treatment was better than the respective treatment.