Gynecological clinic, when I read the patient’s test sheet by Ms. Liu, she told her that she had bacterial vaginal disease, and she pointed at the conventional I degree of the secretion on the test sheet.normal.What do you say I have vaginitis?
But is the facts really as she said?The majority of female friends may know that vaginal secretions are divided into I degree and II degree mostly, and III degree indicates inflammation.Let me introduce this kind of vaginitis with more cleanliness. Do n’t underestimate this vaginitis, because it can cause a variety of complications, which is the vaginitis with the greatest harm to pregnancy.
Bacterial vaginitis (BV) is a hybrid infection caused by normal flora disorders in the vagina, but clinical and pathological characteristics have changed without inflammation.
1. In the normal vagina, the germine that produces hydrogen peroxide accounted for the advantage. When the lactobacillus that can produce hydrogen peroxide in the vagina decreases, and other microorganisms can be reproduced in large quantities, there are mainly Gudena, anaerobic bacteria (Dynamic bacteria, andPredae, Purple Monococcus, Bacterium, digestive link bacteria, etc.) and human -shaped mycoplasma, most of which are anaerobic bacteria, and the number of anaerobic bacteria can increase by 100 to 1000 times.
2. Creative factors: multi -sex companion, vaginal rinse, smoking, poor economic conditions, racial factors, in -palaces, oral sex, premature sexual intercourse, menstrual sexual intercourse, homosexual intercourse.
2. Clinical manifestations
1. Symptoms: 10 ~ 40%asymptomatic. Those with symptoms are mainly manifested as the increase in vaginal secretions, with fishy smell, especially after sexual intercourse, which can be accompanied by mild vulvar itching or burning sensation.The secretions are fishy smell due to anaerobic bacteria that can produce amine.
2. Symptoms: Check the inflammation of the vaginal mucosa without congestion. The secretions are gray -white, uniform, thin, and often adhere to the vaginal wall, but the viscosity is very low, which is easy to wipe the secretion from the vaginal wall.Most of the cleanliness is i degree.
Pelvic inflammatory disease, premature birth, postoperative infection, infertility and miscarriage, cervical cancer, low birth weight, HIV infection (the patient’s vaginal pH value is as high as 5.5, it will severely weaken the phagocytosis of neutral granulocytes and the stimulation of chemical stimulationReaction, increasing HIV communication between heterosexuals and susceptibility), newborns infection, puerbaria infection.
Fourth, diagnostic criteria
Asymptomatic people are easily ignored. The following 4 items can diagnose BV with 3 items, of which clue cells are positive.
A. The vaginal secretion is a thin leucorrhea with uniform consistency
B. Vaginal pH> 4.5 (due to ammonia produced by anaerobic bacteria)
C. The ammonia test is positive. Take a small amount of vaginal secretions on the glass tablet and add 1-2 drops of 10%potassium hydroxide solution. If a rotten fish-like smell is produced
D. CLUE CELL is positive, and the suspension method sees more than 20%of the CLUE CLL under the high -power microscope.CLUECELL is the surface of the surface of the vagina falling off the surface of the surface.
5. Treatment syndrome
1. Symptoms of patients
2. Before gynecological surgery
3. Announced asymptomatic pregnant woman: Given BV that can cause premature birth, abortion, low birth weight, etc., asymptomatic pregnant women must be treated.
6. Treatment plan and precautions
1. metronidazole, chloroplasm, tinidazole, etc.
2. Screen BVs with high -risk factors with premature births in order to treat and prevent premature birth early.
3. The application of metronidazole during pregnancy requires the principle of informed consent.
4. The treatment companion does not reduce the recurrence rate and does not require conventional treatment.
5. Homosexual BV patients have increased the incidence of BV.
6. BV recurrence is more common. For those who are persistent or symptoms of symptoms, they should go to the consultation and receive treatment in time.
Seven, follow -up
Symptoms: No follow -up.
Symptoms: Polite follow -up check and identify: BV recurrence?BV hasn’t healed?Non -BV vaginitis?
Seeing this, should female friends start paying attention to this vaginitis, especially when you need to be pregnant, during pregnancy, and surgery, if a bacterial vaginal disease occurs, you must treat it in time. Can you do it?