腹腔镜下全子宫切除术对子宫病变患者盆底功能及免疫功能的影响

Effect of Laparoscopic Hysterectomy on Pelvic Floor Function and Immune Function in Patients with Uterine Diseases

【目的】探讨腹腔镜下全子宫切除术对子宫病变患者盆底功能及免疫功能的影响。【方法】选取2016年6月至2018年10月在中信中心医院诊治的80例需行全子宫切除术的患者作为研究对象,根据治疗方法不同分为观察组和对照组,每组40例。观察组行腹腔镜下全子宫切除术,对照组行开腹全子宫切除手术。比较两组患者手术前后盆底功能影响问卷简表7(PFIQ-7)评分、盆底功能障碍问卷(PFDI-20)评分、T淋巴细胞亚群、免疫球蛋白及补体水平变化。【结果】两组患者术后6个月、12个月PFDI-20、PFIQ-7评分均高于术前,术后12个月PFDI-20、PFIQ-7评分均高于术后6个月(F<0.05),但观察组术后各时段PFDI-20、PFIQ-7评分均低于对照组(P<0.05);两组患者术后IgG水平均有所下降,但观察组手术后IgG水平明显高于对照组(P<0.05);两组患者术后补体C4、C3水平较术前降低,但观察组术后C4、C3水平高于对照组(P<0.05);对照组患者术后CD4^(+)、CD3^(+)、CD8^(+)及CD4^(+)/CD8^(+)水平较术前显著降低,与观察组术后比较,差异有统计学意义(P<0.05)。【结论】腹腔镜下子宫全切术后对患者盆底功能、免疫功能影响较小,值得临床推广应用。

【Objective】To investigate the effect of laparoscopic hysterectomy on pelvic floor function and immune function in patients with uterine diseases.【Methods】A total of 80 patients who underwent hysterectomy in.Zhongxin Central Hospital from June 2016 to October 2018 were selected and divided into the observation group and the control group(with 40 cases in each group)according to the treatment method.The observation group was treated with laparoscopic hysterectomy,while the control group was treated with open hysterectomy.The changes of PFIQ-7,PFDI-20,T lymphocyte subsets,immunoglobulin and complement levels were compared between the two groups before and after operation.【Results】The scores of PFDI-20 and PFIQ-7 at 6 and 12 months after operation in the two groups were higher than those before operation and(P<0.05),while the scores of PFDI-20 and PFIQ-7 at 12 months after operation were higher than those at 6 months after operation(P<0.05).PFDI-20 and PFIQ-7 scores of the observation group were lower than those of the control group(P<0.05).The IgG level in the two groups decreased*while the level of IgG in the observation group were significantly higher than that in the control group(P<0.05).The levels of C4 and C3 in the observation group were higher than those in the control group(P<0.05).Level of CD4^(+),CD3^(+),CD8^(+) and CD4^(+)/CD8^(+)in the control group were significantly lower than those in the observation group;The differences were statistically significant(P<0.05).【Conclusion】Lapa-roscopic hysterectomy can improve the immune function of patients,and has little effect on the pelvic floor function.