目的 探讨子宫切除术后阴道残端人乳头瘤病毒（HPV）感染基因型分布现状，分析HPV感染对阴道残端上皮细胞病变的影响。方法 收集扬州大学附属盐城妇幼保健院2021年1月至2024年12月妇科行子宫切除术后阴道残端脱落细胞HPV基因分型检测阳性患者191例，回顾分析患者HPV基因型分布特征及其与阴道细胞病变的关系并进行统计学分析。结果 191例患者中共检出23种HPV亚型，高危型HPV感染前6位的基因型为52、16、58、31、51及18亚型，单一型阳性者、两种阳性亚型及多重阳性病例分别为102例（53.40％）、54例（28.27%）及26例（13.61%），最多1例患者感染6种亚型。阴道镜检查结果显示，无上皮内病变或恶性肿瘤（NILM）73例（38.22%），阴道上皮内瘤变（VaIN）Ⅰ级95例（49.74%），VaINⅡ级20例（10.47%）及VaINⅢ级3例（1.57%）。HPV感染亚型数量与子宫切除术手术指征及阴道残端上皮细胞病理学程度关系差异无统计学意义，阴道残端感染HPV16基因型与阴道残端上皮细胞病理学程度间有统计学差异。结论 阴道残端HPV感染基因型地区分布不同，推荐盐城地区妇女优先选择HPV九价疫苗，妥善处理HPV感染患者，尤其HPV16阳性者及时规范实施薄层液基细胞学检查（TCT）及阴道镜检查，早期诊断VaIN并及时治疗。

Objective To investigate the distribution of human papilloma virus （HPV） genotypes and analyze the impact of HPV infection on vaginal vault epithelial cell lesions. Methods A total of 191 patients with positive HPV genotyping results from exfoliated vaginal stump cells after hysterectomy at Yancheng Maternal and Child Health Care Hospital Affiliated to Yangzhou University （January 2021-December 2024） were retrospectively analyzed. The HPV genotype distribution and its correlation with vaginal cell lesions were statistically analyzed. Results Twenty-three HPV subtypes were detected in the 191 patients. The top six high-risk HPV genotypes were 52，16，58，31，51，and 18 subtypes. Single-type，dual-type，and multiple-type infections accounted for 102 （53.40%），54 （28.27%），and 26 （13.61%） cases，respectively，with one patient infected by six subtypes. Colposcopy results revealed that there was no intraepithelial lesion or malignancy（NILM）in 73 cases（38.22%），while there was vaginal intraepithelial neoplasia （VaIN） grade I in 95 cases （49.74%），gradeⅡn 20 （10.47%），and gradeⅢin 3 （1.57%）. The number of HPV subtypes showed no statistically significant correlation with hysterectomy indications or vaginal vault epithelial pathology degree. However，HPV16 infection in vaginal stump was significantly associated with the degree of vaginal vault epithelial pathology. Conclusions The genotypes of HPV infection in vaginal stump are distributed differently in different regions. It is recommended that women in Yancheng area should give priority to HPV 9 vaccine，and HPV-infected patients should be properly treated，especially HPV16-positive patients，who should receive timely TCT and colposcopy in a standardized manner for early diagnosis and treatment of VaIN.