腹腔镜子宫切除术和筋膜内子宫切除术对机体相关免疫指标的影响

Influence of laparoscopically hysterectomy and intrafascial hysterectomy on relative immunological indexes

目的:探讨腹腔镜子宫切除术和筋膜内子宫切除术对机体相关免疫指标的影响。方法:选择200例子宫良性病变的患者分为试验组和对照组各100例,试验组给予腹腔镜子宫切除术,对照组行传统的筋膜内子宫切除术,观察两组患者手术时间、术中出血量、住院时间、术后排气时间等手术情况,并且测定两组术前、术后3 d外周血淋巴细胞亚群(CD3、CD4、CD8)水平。结果:经过观察发现试验组患者手术时间明显高于对照组,差异有明显的统计学意义(P<0.05);试验组患者术中出血量、术后肛门排气时间、住院天数均明显低于对照组,差异均有明显的统计学意义(P<0.05),两组患者手术前CD3+T、CD4+T、CD8+T、及CD4+/CD8+T细胞比值、IgA、IgG、IgM水平均无明显的统计学差异(P>0.05),而手术后试验组患者CD3+T、CD4+T、CD8+T、IgA、IgG、IgM水平明显高于对照组,差异均有明显的统计学意义(P<0.05)。结论:腹腔镜子宫切除术创伤较轻,机体免疫指标变化小,可能有一定保护作用。

Objective： To investigate the influence of laparoscopically hysterectomy and intrafascial hysterectomy on relative im- munological indexes. Methods： 200 cases of uterine benign lesions were divided into experimental group and control group, 100 patients with laparoscopieally hysterectomy were experiment group, 100 patients with the intrafascial hysterectomy were control group. The post- operative exhausting time, blood loss, postoperative exhaust time and hospitalization were observed after operation in both groups. Peripheral blood lymphocyte subgroups were measured preoperatively and 3 days following operation. Results： Observed in patients after surgery time was significantly higher than the experimental group, the difference was statistically significant （P〈0. 05 ） ; the blood loss, postoperative anal exhaust time, length of hospital stay in experiment group were significantly lower than the control group,the differences were statistically significant （P〈0.05）. Two groups of patients before surgery CD3~, CIM~, CD8~, CD4~/CD8~, IgA, IgG, IgM levels were no statistically significant differences （P〉 0.05 ） , and post-operative test group patients CD3 ~ , CD4＋, CD8＋, IgA, IgG, IgM levels were significantly higher than the control group, the differences were statistically significant （ P〈0. 05 ）. Conclusion： Lparoscopically hysterectomy was less invasive small changes of immunological function and to protect the immune function.