阴式与开腹子宫手术对免疫功能影响的研究

Effects of Trans-vaginal Versus Trans-abdominal Uterine Operation on Immune Function

目的:研究阴式与开腹子宫手术术前后患者体液免疫、细胞免疫功能的变化,探讨阴式手术对机体免疫功能的影响。方法:选择阴式及开腹子宫手术患者各80例。测定两组术前、术后24小时和术后72小时补体C3、C4,急性期蛋白(CRP),T细胞亚群CD3+、CD4+、CD8+。结果:两组手术前后C4差异均无统计学意义(P>0.05);阴式组C3术后24小时较术前下降明显(P<0.05),术后72小时恢复至术前水平(P>0.05)。开腹组C3术后24小时较术前下降更明显(P<0.01),术后72小时尚未恢复至术前水平(P<0.05)。两组术后24小时、72小时CRP水平较术前显著升高(P均<0.01),组间比较:术后24小时、72小时CRP水平开腹组高于阴式组(P<0.01,P<0.05)。两组术后24小时CD3+、CD4+、CD8+均较术前下降,差异有统计学意义(P<0.05),术后72小时阴式组上述指标上升至接近术前水平(P>0.05),而开腹组CD3+、CD4+仍低于术前水平(P<0.05)。结论:阴式子宫手术比开腹手术对机体免疫功能影响小,有利于患者的恢复。

Objective：To compare the effect of trans-vaginal uterine operation on immune functions withtrans-abdominal uterine operation. Methods：80 patients underwent trans-vaginal uterine operation , and 80 patients underwent trans-abdominal operation were enrolled. The levels of C3, C4, C-Reaction Protein （CRP）, CD3^＋ , CD4^＋, CD8^＋ were measured before the operation , the24 hours and 72 hours after op- eration respectively for each patient. Results ：The levels of C4 were similar before and after surgery in bothgroups（P〉0. 05）. The levels of C3 decreased significantly at the 24 hours postoperatively in tran-vaginal groups（ P 〈 0. 05）, and return to the levels of pre-operation at the postoperative 72-hour（ P 〉 0. 05）. The levels of C3 in the trans-abdominal group decreased more significantly at the postoperative 24-hour （ P 〈 0. 01 ）, and still remained a lower level than pre-operation even at the postoperative 72-hour（ P 〈0.05）.CRP level increased significantly at the 24 hours and 72 hours postoperatively in both groups（ P 〈 0. 01, P 〈 0.01 ）. As compared to trans-vaginal group, CRP level was higher in the trans-abdominal group at the 24 hours and 72 hourspostoperatively（ P 〈0. 01, P 〈 0. 05）. CD3^＋ 、CD4^＋ 、CD8^＋ decreased significantly at the 24 hours after the operation in both groups （P〈0. 05）. The levels in trans-vaginal group at the postopera- tive 72-hourreturned backto the levels at pre-operation（ P 〉 0.05）. However, the levels of CD3^＋ and CD4^＋ in trans-abdominal group at the postoperative 72-hour still stayed at a lower level than pre-operation （ P 〈 0.05）. Conclusions.Compared with trans-abdominal operation , trans-vaginal uterine operation had less im- pact on immune function, and benefited the patient with faster recovery.