腹腔镜治疗盆腔炎性包块临床疗效观察及对患者T细胞免疫功能的影响

Clinical observation of laparoscopic surgery in the treatment of pelvic inflammatory mass and its effect on immune function of T cells in patients

目的对比腹腔镜与开腹手术治疗盆腔炎性包块的临床疗效及对机体细胞免疫功能的影响。方法选择在本院进行治疗的61例盆腔炎性包块患者，按照术式不同进行分组治疗，分别采用腹腔镜与开腹手术。术后观察临床治疗效果及术式对机体细胞免疫功能的影响。结果两种术式临床治疗有效率分别为96％与97．22％（P〉0．05）；两组患者术中出血量、肠道排气时间、血常规恢复时间、体温恢复正常时间及住院时间比较，腹腔镜组患者表现均优于开腹组患者（P〈0．05）；术后72h，腹腔镜患者CD3^＋、CD4^＋及CD4^＋／CD8^＋比值均高于开腹组（P〈0．05），腹腔镜组患者IL-18、IL-10细胞因子指标均到达术前水平（P〉0．05），开腹组患者IL-18、IL-10细胞因子指标与术前比较有统计学差异（P〈0．05）。结论应用腹腔镜手术治疗盆腔炎性包块具有恢复快、损伤小、对机体免疫影响小等优势，可作为治疗盆腔炎性包块的首选方式。

Objective To compare the clinical efficacy of laparoscopic and open surgery in the treatment of pelvic inflammatory mass and their effect on cellular immune function. Methods 61 patients with pelvic inflammatory mass treated in our hospital were divided into two groups, treated with laparoscopic and open surgery respectively. Observed the clinical treatment effect and the cellular immune function. Results The effective rate of clinical treatment was 97.22% in the laparoscopic group and 96% in the laparotomy group （P〉0.05）. The intraoperative blood loss, intestinal exhaust time, blood routine recovery time, body temperature recovery time, and hospitalization time in the laparoscopic group were significantly better than those in the laparotomy group （P〈0.05）. At 72 hours after operation, the levels of CD3^＋, CD4^＋, CD4^＋/CD8^＋ in the laparoscopic group were significantly higher than those in the laparotomy group （P〈0.05）, the levels of IL-18 and IL-10 in the laparoscopic group both reached to preoperative level （P〉0.05）, the levels of IL-18 and IL-10 in the laparotomy group were different from those before operation （P〈0.05）. Conclusion The application of laparoscopic surgery in the treatment of pelvic inflammatory mass has the advantages of quick recovery, small injury, and little effect on immune function, which can be used as the first choice for the treatment of pelvic inflammatory mass.