腹腔镜下治疗卵巢子宫内膜异位囊肿38例临床分析

Clinical analysis of 38 cases with ovarian endometriosis cyst treated under laparoscope

目的:对比腹腔镜与开腹术治疗卵巢子宫内膜异位囊肿疗效及手术一般指标。方法:78例卵巢子宫内膜异位囊肿剔除术患者,根据手术方案不同分为研究组与对照组,研究组进行腹腔镜手术,对照组进行开腹手术。观察两组患者一般手术情况,对手术前后血清免疫球蛋白Ig M、Ig G、Ig A、C3、C4补体以及外周血T细胞亚群CD3、CD4、CD8水平进行检测。结果:两组患者手术时间以及术中出血量均未见差异(P>0.05),但研究组住院时间明显短于对照组(P<0.05)。两组患者治疗前后Ig M、Ig A、C4水平无明显差异(P>0.05)。两组患者Ig G、C3在术后1d即有明显下降,研究组在术后3d恢复至术前水平,而对照组仅有C3恢复至术前水平。CD3、CD4、CD8方面,研究组术后未见明显变化,而对照组在术后1d即见到明显下降,术后3d开始回升。结论:腹腔镜卵巢子宫内膜异位囊肿剔除术对患者机体损伤较小,能够缩短患者住院时间,对细胞免疫和体液免疫功能造成的影响较小。

Objectives： To observe and compare the clinical effect of laparoscope and laparotomy for treatment of ovarian endometriosis cyst（ OEC）. Method： 78 patients with OEC were chosen and divided into study group and control group according to different surgical methods. Study group was given laparoscopic surgery while control group was given laparotomy. General surgical conditions of the two groups were observed,and levels of Ig M,Ig G,Ig A,C3,C4 alexin and CD3,CD4 and CD8 before and after surgery of the two groups were detected. Results：There were no significant differences between the two groups on operation time and bleeding amount during surgery（ P〈0. 05）,but hospital stays of study group was obviously shorter than control group（ P〉0. 05）. There were no significant differences between the two groups on levels of Ig M,Ig A and C4 before and after surgery（ P〉0. 05）.Ig G and C3 of the two groups both declined obviously on the first day after surgery,and those of study group recovered to preoperative level on 3rd day after surgery,but only C3 of control group recovered to preoperative level. In terms of CD3,CD4 and CD8,no obvious changes occurred in study group,but those of control group declined obviously on the first day after surgery and began to rise on 3rd day after surgery. Conclusion： Laparoscopic ovarian endometriosis cyst excision has little damage to bodies of patients,which can shorten hospital stays of patients and has little impact on the function of cellular immunity and humoral immunity.