两种术式对早期宫颈癌患者术后免疫功能的影响

Effect of two surgical methods on postoperative immune function in patients with early-stage cervical cancer

目的研究两种术式对早期宫颈癌患者术后免疫功能的影响。方法 40例早期宫颈癌患者,按手术方法不同分为观察组和对照组,各20例。对照组采用腹式广泛子宫切除手术,观察组采用全腹腔镜广泛子宫切除手术治疗。比较两组围手术期指标、术后膀胱功能障碍率以及血IgA、IgG、IgM和T细胞亚群水平的变化。结果观察组住院时间显著短于对照组(P<0.05);两组术后引流量和膀胱功能障碍发生率无显著差异(P>0.05);术后第1、3 d,观察组IgM显著高于对照组(P<0.05),CD4^+T细胞和CD4^+/CD8^+显著低于对照组(P<0.05),但两组IgA、IgG水平比较无显著性差异(P>0.05)。结论对早期宫颈癌,全腹腔镜广泛子宫切除术治疗恢复时间短,术后免疫球蛋白恢复较快,但腹式手术后T细胞亚群恢复较好,临床上应根据患者的身体状况合理选择手术方案。

Objective To study the effect of two surgical methods on postoperative immune function in patients with early-stage cervical cancer. Methods A total of 40 patients with malignant tumor of early-stage cervical cancer were divided into an observation group and a control group according to different surgical methods（n=20, respectively）. The control group was treated with abdominal radical hysterectomy, and the observation group was treated by laparoscopic radical hysterectomy. The perioperative indicators,postoperative bladder dysfunction and changes of serum IgA, IgG, IgM and T cell subsets were compared between the two groups.Results The hospitalization time of the observation group was significantly shorter than that of the control group（P〈0.05）, and there was no significant difference in the postoperative drainage volume and incidence rate of bladder dysfunction between the two groups（P〈0.05）; on the first and third day after the operation, the IgM levels in the observation group was significantly higher than that in the control group（P〈0.05）, and CD4^＋T cells and CD4^＋/CD8^＋were significantly lower than those in the control group（P〈0.05）, but the IgA and IgG levels had no significant difference between the two groups（P〈0.05）. Conclusion For early-stage cervical cancer,the recovery time after laparoscopic radical hysterectomy is shorter and the recovery of immunoglobulin is faster, but the postoperative recovery of T cell subsets is better, so the surgical plan should be determined according to the patient＇s physical condition.