腹腔镜下子宫肌瘤挖除与经腹手术的炎症应激反应程度比较

Comparison of the degree of inflammatory stress response of laparoscopic myomectomy and abdominal surgery

目的:研究腹腔镜下子宫肌瘤挖除与经腹手术的炎症应激反应程度。方法:选择大邑县妇幼保健院2014年6月～2017年10月期间进行的子宫肌瘤挖除术病例进行回顾性分析,根据手术方法不同分为腹腔镜组及对照组、分别接受腹腔镜手术及开腹手术。手术前及手术后1天,测定血清中炎症因子及应激介质的含量、外周血中炎症分子及应激分子的表达量。结果:与组内手术前比较,两组患者手术后血清中TNF-α、sICAM1、sVCAM1、sTREM1、GH、Cor、C-P、FT4、CRP的含量以及外周血中JAK2、STAT3、Notch2、Hes1、Nrf2、HO-1、MPO、FOXP3的表达强度均显著升高且腹腔镜组患者手术后血清中TNF-α、sICAM1、sVCAM1、sTREM1、GH、Cor、C-P、FT4、CRP的含量以及外周血中JAK2、STAT3、Notch2、Hes1、Nrf2、HO-1、MPO、FOXP3的表达强度均低于对照组。结论:与经腹手术比较,腹腔镜下子宫肌瘤挖除术能够减轻术后炎症应激反应的程度。

Objective：To study the degree of inflammatory stress response of laparoscopic myomectomy and abdominal surgery.Methods：Patients who underwent myomectomy in Maternal and Child Health Hospital of Dayi County between June2014 and October 2017 were retrospectively analyzed,and according to different operation methods,they were divided into the laparoscopy group and the control group who underwent laparoscopic surgery and open surgery respectively.The contents of inflammatory factors and stress mediators in serum as well as the expression of inflammatory molecules and stress molecules in peripheral blood were measured before surgery and 1 day after surgery.Results：Compared with those of same group before surgery,serum TNF-α,sICAM1,sVCAM1,sTREM1,GH,Cor,C-P,FT4 and CRP levels as well as peripheral blood JAK2,STAT3,Notch2,Hes1,Nrf2,HO-1,MPO and FOXP3 expression intensity of both groups of patients were significantly higher after surgery,and serum TNF-α,sICAM1,sVCAM1,sTREM1,GH,Cor,C-P,FT4 and CRP levels as well as peripheral blood JAK2,STAT3,Notch2,Hes1,Nrf2,HO-1,MPO and FOXP3 expression intensity of laparoscopy group of patients after surgery were lower than those of control group.Conclusion：Compared with abdominal surgery,laparoscopic myomectomy can reduce the degree of postoperative inflammatory stress response.