妇科良性肿瘤腹腔镜子宫全切术与开腹子宫全切术的疗效对比及对机体免疫功能的影响

Efficacy comparison of benign gynecologic treated by laparoscopic hysterectomy and abdominal hysterectomy and its effect on immune function

目的分析妇科良性肿瘤腹腔镜子宫全切术与开腹子宫全切术的疗效及对机体免疫功能的影响。方法选择2010年11月~2014年9月湖北省第三人民医院妇产科收治的因妇科良性肿瘤需行子宫全切术的患者68例为研究对象,依据手术方式不同分为观察组和对照组,观察组36例患者行腹腔镜子宫全切术,对照组32例患者行开腹子宫全切术,比较两组患者术中和术后情况及术前1 d、术后1 d、术后3 d血清Ig G、C3、白介素（IL）-2及IL-4水平。结果观察组患者术中出血量显著少于对照组,术后排气时间及术后住院天数均显著短于对照组（P〈0.05）。术后1、3 d,两组患者血清Ig G、C3均较术前显著降低,但观察组显著高于对照组（P〈0.05）。术后1、3 d,两组患者血清IL-2水平均较术前显著降低,但观察组显著高于对照组（P〈0.05）;术后1、3 d,对照组患者IL-4水平均较术前显著升高,但观察组显著低于对照组（P〈0.05）。两组并发症情况比较,差异无统计学意义（P〉0.05）。结论腹腔镜子宫全切术应用于妇科良性肿瘤能够显著减少术中出血量,缩短术后排气时间及术后住院天数,减小对机体免疫功能的影响,值得临床推广应用。

Objective To analyze the efficacy of benign gynecologic treated by laparoscopic hysterectomy and abdominal hysterectomy and its effect on immune function. Methods 68 patients with benign gynecologic needed to undergone hysterectomy from November 2010 to September 2014 in Gynaecology and Obstetrics Department, the Third People′ s Hospital of Hubei Province were selected as study objects. They were divided into observation group and control group according to the operation scheme, laparoscopic hysterectomy was used in observation group of 36 patients and abdominal hysterectomy was applied in control group of 32 patients. Intraoperative and postoperative conditions, Ig G, C3, IL-2 and IL-4 levels preoperative 1 d and postoperative 1 and 3 d between two groups were compared. Results Intraoperative blood loss of observation group was less than that of control group, postoperative exhaust time and hospital stay of observation group were shorter than those of control group（P〈0.05）. Postoperative 1and 3 d, serum Ig G, C3 of two groups were significantly lower than those before operation, observation group was significantly higher than that control group（P〈0.05）. Postoperative 1 and 3 d, serum IL-2 of two groups were significantly lower than those before operation, observation group was significantly higher than that control group（P〈0.05）. Postoperative 1 and 3 d, serum IL-4 of control group were significantly higher than those before operation,observation group was significantly lower than that control group（P〈0.05）. Complication had no significant difference between two groups（P〈0.05）. Conclusion Laparoscopic hysterectomy applied to benign gynecologic can significantly reduce intraoperative blood loss, shorten postoperative exhaust time and hospital stay, reduce the impact on the immune function, it is worthy of clinical popularization and application.