鲁丽丽 刘建华

[摘要] 目的 研究结肠代阴道、皮肤代阴道及COOK生物补片代阴道这三种人工阴道成形术后阴道优势菌群和乳酸杆菌定植情况。 方法 选择2014年1月～2016年1月在上海交通大学医学院附属第九人民医院施行阴道成形术患者为研究对象，其中结肠代阴道、皮肤代阴道及COOK生物补片代阴道术患者各12例。分别于术后1个月、术后6个月及术后1年取其阴道分泌物，选用不同的细菌培养基进行培养从而得出阴道优势菌群，并检测这三种人工阴道内是否有乳酸杆菌定植。 结果 三种人工阴道成形术后阴道优势菌群各不相同，术后1个月、术后6个月及术后1年部分患者阴道优势菌存在变异，4例结肠代阴道及3例COOK生物补片代阴道的患者人工阴道内检测出乳酸杆菌。 结论 三种人工阴道成形术后阴道优势菌群呈现各自特点，部分结肠代阴道及COOK生物补片代阴道的人工阴道内检测到有乳酸杆菌定植，这些患者的阴道微生态环境可能更趋近于正常女性。

[关键词] 结肠代阴道；皮肤代阴道；COOK生物补片代阴道；阴道优势菌；乳酸杆菌

[中图分类号] R713.31 [文献标识码] A [文章编号] 1673-7210（2018）02（b）-0098-05

[Abstract] Objective To investigate the vaginal predominant bacteria distribution and the existence of Lactobacilli after sigmoid vaginopalsty， skin graft vaginoplasty and COOK soft tissue graft vaginoplasty. Methods Twelve women with sigmoid vaginopalsty， 12 women with skin graft vaginopalsty and 12 women with COOK soft tissue graft vaginopalsty from January 2014 to January 2016 in Shanghai Ninth People's Hospital Affiliated to School of Medicine of Shanghai JiaoTong University. These patients underwent vaginopalsty were selected. The vaginal discharge in the cases were collected respectively at 1 month， 6 months and 1 year after vaginopalsty. Various kinds of bacteria culture media were used to identify the predominant bacteria and to detect vaginal Lactobacilli in the cases. Results The predominant bacteria distributions in the three kinds of artificial vagina were different. The species of vaginal predominant bacteria varied at 1 month， 6 months and 1 year after vaginopalsty in some cases. Vaginal Lactobacilli had been found in 4 women with sigmoid vaginopalsty and 3 women with COOK soft tissue graft vaginopalsty. Conclusion The vaginal predominant bacteria distributions after the three kinds of vaginoplasty present their respective characteristics. Several patients with sigmoid vaginopalsty and with COOK soft tissue graft vaginopalsty have Lactobacilli in their artificial vagina. These patients′ vaginal microecological environment may be closer to that of healthy women.

[Key words] Sigmoid vaginopalsty； Skin graft vaginoplasty； COOK soft tissue graft vaginoplasty； Vaginal predominant bacteria； Lactobacilli

各種阴道畸形的患者都希望建造一个解剖及功能接近于正常女性的阴道。阴道成形术式繁多，包括乙状结肠代阴道术、皮肤代阴道术、羊膜代阴道术、腹膜代阴道术以及Frank法压迫阴道成形等各种方法。2011年起上海交通大学医学院附属第九人民医院（以下简称“我院”）妇科采用猪小肠黏膜下层生物补片（Surgisis，Cook Medical，Bloomington，IN，U.S.A.）（简称“COOK生物补片”）作为人工阴道壁的内衬。……