[摘要]目的探讨二氧化碳（CO2）激光治疗对细菌性阴道病（BV）及外阴阴道假丝酵母菌病（VVC）复发情况、 阴道微环境的影响。方法选择2020年6月至2022年1月在柳州市工人医院妇科门诊就诊的100例BV及 VVC患者作为研究对象，将患者按随机数字表法分为实验组（50例）及对照组（50例）。对照组进行规范的 药物治疗，实验组拟行总疗程共3~5次CO2激光治疗。治疗后共随访3个月，对比两组患者随访期间BV及 VVC的复发率、复发次数。随访3个月时均进行阴道微生态检测及功能学检测，比较两组阴道微生态变化 情况。结果实验组复发率、复发次数≥2次占比均低于对照组（P<0.05）。实验组阴道菌群密集度、阴道菌 群多样性均优于对照组（P<0.05）；实验组H2O2阳性率、pH值3.8~4.5占比均高于对照组（P<0.05）；实验组 Nugent评分、白细胞酯酶阳性占比均低于对照组（P<0.05）。结论CO2激光治疗可有效改善和保障患者阴 道微环境平衡，可有效治疗BV及VVC并预防复发，效果显著。

[Abstract] Objective To investigate the effect of carbon dioxide (CO2) laser therapy on the recurrence of bacterial vaginosis (BV) and vulvovaginal candidiasis (VVC), and vaginal microenvironment. Methods A total of 100 patients with BV and VVC who were hospitalized in the Gynecological Outpatient Department of Liuzhou Workers’ Hospital from June 2020 to January 2022 were selected as study subjects. The study subjects were divided into the experimental group (50 cases) and the control group (50 cases) according to the random number table method. The control group received standardized drug treatment, and the experimental group was planned to receive a total course of CO2 laser treatment of 3-5 times. After treatment, a total of 3 months of follow-up was conducted to compare the recurrence rate and frequency of BV and VVC between the two groups during the follow-up period. At the follow-up of 3 months, vaginal microecology tests and functional tests were conducted to compare the changes in the microecology of the two groups. Results The recurrence rate and the percentage of recurrence frequency ≥ 2 times in the experimental group were lower than those in the control group (P < 0.05). The vaginal flora density and diversity of the experimental group were better than those of the control group (P < 0.05). The positive rate of H2O2 and the proportion of pH3.8-4.5 in the experimental group were higher than those in the control group (P < 0.05), while the Nugent score and the proportion of leukocyte esterase positive were lower than those in the control group (P < 0.05). Conclusion CO2 laser therapy can effectively improve and ensure the balance of vaginal microenvironment in patients with BV and VVC, and can effectively treat BV and VVC and prevent recurrence with remarkable effect.

R711.31

广西壮族自治区卫生健康委员会自筹经费科 研课题（Z20210658）。