腹腔镜与开腹卵巢囊肿剥除术对机体免疫功能及术后近远期卵巢功能的影响

Effect of oophorocystectomy under laparoscope and cystectomy under laparotomy on ovarian function of body's immune function in short and long term

目的:探讨腹腔镜与开腹卵巢囊肿剥除术对患者机体免疫功能及术后近、远期卵巢功能的影响。方法:将院内收治的92例卵巢良性肿瘤患者根据手术方式不同随机分为观察组和对照组,对照组实行开腹卵巢囊肿剔除术治疗,观察组应用腹腔镜囊肿剔除术治疗,比较两组术前和术后机体免疫功能及近、远期卵巢功能情况。结果:(1)观察组住院时间显著短于对照组(P<0.05)。(2)与术前比较,两组术后1d时IgG及C3指标水平均明显下降(P<0.05),且对照组下降更为明显,组间比较差异有统计学意义(P<0.05);术后3d对照组C3水平恢复正常但IgG仍明显低于观察组,组间比较差异有统计学意义(P<0.05);对照组术后1d时CD3、CD4、CD8及CD4/CD8指标均显著下降(P<0.05),术后3d除CD3水平逐渐接近正常外其余各指标均显著低于观察组和术前水平(P<0.05)。(3)与术前比较,术后1个月时两组E2水平明显下降、FSH及LH水平明显升高(P<0.05),且对照组改变程度更为明显,组间比较差异有统计学意义(P<0.05);术后3个月、1年时观察组上述各指标恢复情况明显优于对照组,组间比较差异有统计学意义(P<0.05),而对照组各指标变化程度与术前比较差异仍有统计学意义(P<0.05);观察组术后1月、3月及1年时PSV水平明显升高、PI和RI水平显著降低,与术前及同期对照组比较差异均有统计学意义(均P<0.05),观察组术后2年PI、RI及PSV的变化明显优于对照组,组间比较差异均有统计学意义(P<0.05)。结论:与开腹卵巢囊肿剥除术比较而言,腹腔镜囊肿剔除术对患者的免疫功能、近期和远期卵巢功能等影响较小,值得临床应用。

Objective： To investigate the effect of oophorocystectomy under laparoscope and cystectomy under laparotomy on ovarian function of body＇s immune function in short and long term. Methods： A total of 92 cases of benign ovarian tumor admitted to hospital were randomly divided into observation group and the control group. Patients in the control group to implement open excision of ovarian cysts treatment, observation group, laparoscopic cyst removed for treatment, according to the surgical technique were compared immune function before and after surgery and the short and long term situation of ovarian function. Methods： The 92 cases of benign ovarian tumor admitted to hospital were randomly divided into observation group and the control group. Patients in the control group had cystectomy under laparotomy, while patients in observation group had oophorocystectomy under laparoscope. Preoperative and postoperative immune function and short and long term situation of o- varian function were detected and compared. Results： （1） The length of stay of observation group was significantly shorter than the control group （P〈0.05）. （2）IgG and C3 index levels 1 d after surgery were significantly lower than that of the preoperative time （P〈0.05）, but decreased more significantly in the control group （P〈0.05）; C3 and IgG levels 3 day after surgery re- turned to normal in control group, hut still significantly lower than the observation group （P〈0.05）; In the control group CD3, CD4, CD8 and CD4 / CD8 indexes were significantly decreased 1 d after surgery （P〈0.05）. CD3 was approaching normal levels 3 day after surgery, and the rest of the indicators were significantly lower than in the observation group and the normal level （P〈0.05）. @In two groups E2 levels were decreased after a month, FSH and LH levels were significantly in- creased （P〈0.05）, but the degree of change is more significant in the control group （P〈0.05）; after three months and one year, the recovery in observation group was more significant than the control group （P〈0.05）. In observation group PI and RI were significantly decreased, PSV was increased significantly 1 month, three months and one year after surgery, respectively （P〈0.05）. After 2 years changes in PI, RI and PSV were more significant better than the control group （P〈0.05） between groups. Conclusion.. Compared with eystectomy under laparotomy, oophorocystectomy under laparoscope has light effect on immune function in short-term and long-term, and it is worthy of clinical application.