三角形子宫切除术对术后恢复及免疫系统的影响

Study on the Impact of Triangle Hysterectomy on Post Operative Recovery and Immune System

目的观察三角形子宫切除术对术后恢复、免疫系统的影响。方法观察2006年1月至2007年2月在河北省人民医院行选择三角形子宫切除术患者50例(三角切组),行子宫切除术的患者50例作为全切组。观察手术时间、术中出血量等以及手术当日和术后72 h的白细胞介素(IL)-6、IL-8、免疫球蛋白的比较。结果三角形子宫切除术组与子宫全切组的术中出血量分别为(69.43±18.23)mL、(91.92±19.29)mL,手术时间分别为(65.6±37.6)min、(73.8±36.8)min,两组比较差异无统计学意义(P>0.05)。术后恢复排气的时间分别为(18.0±9.0)h、(23.0±8.0)h、术后下床活动的时间分别为(19.0±2.5)h、(23.0±2.2)h。两组患者术后血清中的IL-6分别为(20.48±8.41)ng/L、(32.47±16.87)ng/L,IL-8分别为(38.48±17.23)ng/L、(45.13±18.11)ng/L,比较有统计学意义(P<0.05);与术前相比全切组增高的程度显著高于三角切组(P<0.05);术后IgM型免疫球蛋白分别为(1.14±0.07)g/L、(1.53±0.04)g/L,两组相比无统计学意义(P>0.05)。IgG型免疫球蛋白分别为(10.11±2.43)g/L、(9.88±2.04)g/L,两组血清IgG下降水平比较有统计学意义(P<0.05)。结论三角形子宫切除术组手术后恢复快,并发症少,手术操作更易掌握,引起机体免疫功能变化小,这为术后快速恢复提供了病理生理基础。

Objective To observe the impact of triangle subtotal hysterectomy on post operative recovery and immune system. Methods A total of 50 premenopausal women with benign uterine diseases underwent triangle hysterectomy in Hebei People＇s Hospital from Jan. 2006 to Feb. 2007 were selected as the observation group, another 50 women who underwent hysterectomy were selected as the control group. The operation time,volume of intraoperative bleeding,and levels of IgG,IgM,IgA IL-6 and IL-8 in sera before and 72 h after operation of the two groups were compared. Results The volumes of intraoperative bleedling of the observation group and the control group were respectively （69.43 ±18.23） mL and （65.6 ±37.6） mL, mean operation time of the two groups was （65.6 ± 37.6） min and （ 73.8 ± 36.8 ） min, there were no staffstically significant differences between the two groups （ P 〉 0.05 ）. Time of post-operative exhausting recovery, time of post-operative off-bed activity, serum IL-6 levels and IL-8 levels of the two groups were repectively [ （18 ±9） h vs（23 ±8） h] ,[ （19.0 ±2.5） h vs （23.0 ±2.2） h] ,[ （20.48 ±8.41） ng/L vs （32.47 ± 16.87） ng/L], [ （38.48 ± 17.23 ） ng/L vs （45.13 ±18.11 ） ng/L], there were statistically significant differences between the two groups （ P 〈 0.05 ）. IL-6 and IL-8 levels of the control group increased more significantly 72 h after operation than the observation group （P 〈 0.05 ）. There were no statistically significant difference of IgM levels between the two groups after operation[ （ 1.14 ±0.07 ） g/h vs （ 1.53 ±0.04） g/L, P 〉 0.05 ]. IgG levels of the observation group decreased more significantly 72 h after operation than the contrelgroup[（10.11 ±2.43） g/Lvs（9.88±2.04） g/L,P〈0.05].Conelusion Patients underwent triangle hysterectomy recover quickly,with less complications, and the operation is easy to carry out and causes less change to the immune system of the patient,which would be advantageous for a rapid recovery.