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经常穿漂亮裙子和时髦牛仔裤的小公主们，常有小屁股痒的情况，妈妈看见她们又抓又挠的可心烦了。今天和大家讨论下青春期前儿童常见的外阴阴道疾病：非特异性阴道炎。儿童群体是存在若干增加外阴阴道炎风险潜在因素：阴唇未发育、未雌激素化的薄弱黏膜、比月经初潮后女孩/女性的阴道pH值偏碱性(pH7)、卫生状况不佳、泡沫浴、洗发剂、除臭皂、肥胖、异物以及选择的衣物(紧身连衣裤、紧身裤袜、牛仔裤)。
Nonspecific vulvovaginitis is the commonest gynecological problem in prepubertal girls. There are a number of potential factors in children that increase their risk of vulvovaginitis, including lack of labial development, unestrogenized thin mucosa, more alkaline pH (pH 7) than postmenarchal girls/women, poor hygiene, bubble baths, shampoos, deodorant soaps, or other irritants, obesity, foreign bodies, and choice of clothing (leotards, tights, and blue jeans).
●避免连身睡衣，穿睡袍需保证空气流通。
●采用棉质内裤。内衣物在洗涤后应多次漂洗以免刺激物残留，应避免将织物柔软剂用于内衣物或泳衣。
●避免穿紧身裤袜、紧身连衣裤和绑腿裤。选择裙装和宽松的裤子以利于空气流通。
●每日温水沐浴也有帮助，如下：
让儿童泡在清洁水中(无肥皂)10-15分钟。尚未有人专门对在水中加入醋或小苏打进行研究，但是根据我们的经验，该方法并不比仅用清水更有效。
在儿童离开盆浴前使用肥皂清洗除生殖器区以外的区域，生殖器区限制使用任何肥皂。
充分冲洗生殖器区并轻柔拍干。
冷风模式的吹风机可能有助于干燥生殖器区。
●不要使用泡沫浴或香皂。
●如果外阴部触痛或肿胀，冷敷可缓解不适。擦拭时可使用湿巾代替厕纸，润肤剂可能有助于保护皮肤。
●检查儿童的卫生习惯。强调排便后从前往后擦拭，让其在坐下时分开双膝以减少尿液反流进入阴道。如果由于其体型小而难以保持该姿势，则可以使用较小的可拆卸坐便椅或向后坐在坐便器上(面对坐便器)，应当指导或帮助5岁以下儿童的如厕卫生。
●避免让儿童在游泳后穿着湿的游泳衣坐较长时间。
The following techniques and tips for parents may be of help to improving vulvovaginitis:
●Avoid sleeper pajamas. Nightgowns allow air to circulate.
●Cotton underpants. Double-rinse underwear after washing to avoid residual irritants. Do not use fabric softeners for underwear and swimsuits.
●Avoid tights, leotards, and leggings. Skirts and loose-fitting pants allow air to circulate.
●Daily warm bathing is helpful as follows:
Allow the child to soak in clean water (no soap) for 10 to 15 minutes. Adding vinegar or baking soda to the water has not been specifically studied but from our experience is not more efficacious than clean water alone.
Use soap to wash regions other than the genital area just before taking the child out of the tub. Limit use of any soap on genital areas.
Rinse the genital area well and gently pat dry.
A hair dryer on the cool setting may be helpful to assist with drying the genital region.
●Do not use bubble baths or perfumed soaps.
●If the vulvar area is tender or swollen, cool compresses may relieve the discomfort. Wet wipes can be used instead of toilet paper for wiping. Emollients may help protect skin.
●Review hygiene with the child. Emphasize wiping front-to-back after bowel movements. Have her sit with knees apart to reduce reflux of urine into the vagina. If she has trouble with this position because of small size, she can use a smaller detachable seat or sit backwards on the toilet (facing the toilet). Children younger than five should be supervised or assisted in toilet hygiene.
●Avoid letting children sit in wet swimsuits for long periods of time after swimming.
这些方法通常可以使非特异性黏液样分泌物和/或气味在2-3周内消失。如果症状持续存在或复发，则应当考虑异物或特异性感染的可能，家长需就医解决问题。
These techniques usually result in resolution of nonspecific mucoid discharge and /or odor within two to three weeks. If symptoms persist or recur, the possibility of a foreign body or specific infection should be considered. See your paediatrician for consultation.
