加速康复干预对全子宫切除术后机体免疫功能的影响

Effects of accelerated rehabilitation intervention on the immune function of patients after total hysterectomy

目的探讨加速康复干预对全子宫切除术后机体免疫功能的影响。方法选择接受阴式全子宫切除术治疗患者98例,随机分为干预组和对照组,每组49例。对照组采取常规围术期管理方案,干预组采取加速康复干预方案,比较2组患者术后康复指标、炎症反应指标以及T细胞亚群变化情况。结果干预组患者术后留置尿管时间、排气时间、下床活动时间、住院时间以及住院费用均显著低于对照组(P<0.05)。术后2组患者血清CRP、IL-6水平较术前显著升高(P<0.05),且术后对照组患者血清CRP、IL-6水平显著高于干预组(P<0.05)。术后2组患者CD3^+、CD4^+、CD4^+/CD8^+水平均较术前显著降低(P<0.05),且术后对照组患者CD3^+、CD4^+、CD4^+/CD8^+水平显著低于干预组(P<0.05)。2组术后并发症发生率差异无统计学意义(P>0.05)。结论对于全子宫切除术患者采取加速康复干预有助于患者术后机体功能康复,减轻还术后炎症反应,同时对机体免疫功能有较好的保护作用,值得临床推广。

Objective To explore the effects of accelerated rehabilitation intervention on the immune function of patients after total hysterectomy.Methods A total of 98 patients who underwent vaginal total hysterectomy were randomly divided into intervention group(n=49)and control group(n=49).The patients in control group were treated by conventional perioperative management scheme,however,the patients in intervention group were treated by accelerated rehabilitation intervention scheme.The postoperative rehabilitation indexes,inflammatory response indexes and the changes of T cell subset were observed and compared between the two groups.Results The time of postoperative indwelling catheter,evacuating time,ambulation time,hospitalization time and hospitalization expenses in intervention group were significantly lower than those in control group(P<0.05).The serum levels of CRP and IL-6 in both groups were significantly higher than those before operation(P<0.05),moreover the serum levels of CRP and IL-6 in control group were significantly higher than those in intervention group(P<0.05).After operation,the levels of CD3^+,CD4^+and CD4^+/CD8^+in both groups were significantly lower than those before operation(P<0.05),moreover the levels of CD3^+,CD4^+and CD4^+/CD8^+in control group were significantly lower than those in intervention group(P<0.05).In addition there was no significant differences in the incidence rate of postoperative complications between the two groups(P>0.05).Conclusion The accelerated rehabilitation intervention for patients undergoing total hysterectomy is contributed to postoperative function recovery of body,reducing postoperative inflammatory reaction,moreover,which has protective effects on immune function of patients,therefor,it is worthy of clinical promotion.