生殖道解脲支原体和沙眼衣原体的感染与输卵管妊娠关系探究

目的 探讨分析生殖道解脲支原体和沙眼衣原体的感染与输卵管妊娠的关系。方法 选取新疆医科大学第二附属医院2018年1月—6月妇科住院经腹腔镜手术证实输卵管妊娠并行患侧输卵管切除的患者作为研究组，同期腹腔镜下行妇科良性疾病输卵管或附件切除术者为对照组，分别采集两组宫颈管分泌物、输卵管组织进行解脲支原体培养以及沙眼衣原体检测，并作宫颈分泌物解脲支原体药敏试验。结果 输卵管妊娠组的宫颈分泌物及输卵管组织中解脲衣原体检出率（34.3%、30.2%）及沙眼衣原体的检出率（18.6%、16.2%）明显高于对照组宫颈分泌物及输卵管中解脲衣原体检出率（16.2%、6.9%）及沙眼衣原体的检出率（4.6%、2.3%），对照组与实验组两组比较差异具有统计学意义（χ2=3.909、4.074、7.679、4.962，Ps＜0.05）。本研究22例宫颈解脲支原体感染中，解脲支原体对交沙霉素、强力霉素、美满霉素、阿奇霉素、克拉霉素的敏感率均高于80%。结论 输卵管妊娠与生殖道解脲支原体及沙眼衣原体感染有密切关系，临床工作中应尽早筛查和诊断，并根据药敏试验进行预防及合理治疗用药，减少输卵管妊娠的发生。

Relationship between Ureaplasma urealyticum/Chlamydia trachomatis infection of reproductive tract and tubal pregnancy

Objective To explore the relationship between genital tract Ureaplasma urealyticum/Chlamydia trachomatis infection and tubal pregnancy．Methods The patients with tubal pregnancy confirmed by laparoscopic surgery and salpingectomy on the affected side in our hospital from January to June 2018 were selected as the observation group，with those with benign gynecological diseases underwent tubectomy or adnexactomy under laparoscopy as the control group．The specimens of cervical tube secretion and fallopian tube tissues were collected for Ureaplasma urealyticum culturing and Chlamydia trachomatis detection，and the Ureaplasma urealyticum in cervical secretions were detected for drug sensitivity．Results The detection rates of Chlamydia urealyticum（34.3%，30.2% vs 16.2%，6.9%）and Chlamydia trachomatis（18.6%，16.2% vs 4.6%，2.3%）in cervical secretion and oviduct tissue in the observation group were significantly higher than those in the control group respectively（χ2=3.909，4.074，7.679，4.962，Ps<0.05）．In the 22 cases of Ureaplasma urealyticum infection，the sensitivity rates to josamycin，doxycycline，minocycline，azithromycin and clarithromycin were higher than 80%．Conclusion Tubal pregnancy is closely related to Ureaplasma urealyticum/Chlamydia trachomatis infection of reproductive tract．Early screening and diagnosis as well as rational use of drugs based on drug sensitivity test can help to prevent and reduce the occurrence of tubal pregnancy．