探讨应用硅胶子宫托治疗子宫脱垂患者的阴道微生态特征，从微生态角度对提高子宫托持续佩戴成功率给予指导，为子宫托保守治疗更换频率提供客观依据。

收集2018年12月至2020年12月就诊于首都医科大学附属北京朝阳医院妇科门诊子宫脱垂佩戴环形带膜子宫托治疗女性43例，在佩戴子宫托之前、佩戴后2周及3个月采集阴道分泌物行阴道微生态检测，分析持续佩戴不同时间段其阴道微生态的总体特征，对佩戴子宫托前及佩戴2周及3个月后患者生活质量问卷评分进行比较。

阴道微生态检测中，佩戴子宫托后患者不同时间段均存在不同程度的微生态失衡，佩戴2周阴道菌群密集度高于佩戴前及佩戴后3个月组，差异有统计学意义（P<0.05）；佩戴子宫托2周组菌群抑制率明显高于佩戴前及佩戴后3个月组，但差异无统计学意义（P>0.05）。佩戴子宫托2周组阴道pH值高于佩戴前及佩戴后3个月组，但差异无统计学意义（P>0.05）。佩戴子宫托后各时间点盆底功能影响的问卷—简表7和盆底困扰量表简表-20问卷评分均显著下降，与治疗前比较，差异有统计学意义（P<0.05）。

阴道微生态在佩戴子宫托2周左右发生明显改变，易出现菌群失调，易导致阴道炎，但随着佩戴时间延长，阴道微环境调整逐渐恢复至佩戴前状态，持续佩戴3个月环形子宫托可用于子宫脱垂的保守治疗。

To explore vaginal microecological characteristics of female pelvic organ prolapse using silicone pessary, and to provide guidance for improving the success rate of continuous wearing of pessary from the perspective of microecology, and to provide objective basis for the replacement frequency of conservative treatment of pessary.

A total of 43 women who were treated with a ring silicone membrane pessary for uterine prolapse in Beijing Chaoyang Hospital from December 2018 to December 2020 were collected. Vaginal secretions were collected for testing vaginal microecology, before wearing the pessary, at 2 weeks and 3 months after wearing the pessary, and the overall characteristics of vaginal microecology for women who continuous wearing the pessary at different time periods were analyzed. The quality of life questionnaire scores were compared before and after 2 weeks and 3 months of using silicone pessary.

There were different degrees of microecological imbalance in the patients after wearing the pessary at different time. The concentration of vaginal flora at 2 weeks after wearing the pessary was higher than that before wearing and at 3 months after wearing the pessary, with statistical significance (P<0.05). The microflora inhibition rate in the group wearing pessary for 2 weeks was significantly higher than that in the group before and at 3 months after wearing pessary, but there was no statistical significance (P>0.05). Vaginal pH value of the group wearing pessary for 2 weeks was higher than that of the group before and 3 months after wearing pessary, but there was no statistical significance (P>0.05). PFIQ-7 and PFDI-20 scores were significantly decreased at 2 weeks and 3 months after wearing pessary, and the differences were statistically significant compared with those before treatment (P<0.05).

Vaginal microecology changed significantly about 2 weeks after wearing the pessary, which was prone to maladjustment of bacterial flora and vaginitis. However, with the extension of wearing time, the adjustment of vaginal microenvironment gradually recovered to the state before wearing. The continuous wearing of a ring pessary for 3 months could be used for conservative treatment of uterine prolapse.