微创手术治疗卵巢良性肿瘤对围手术期相关指标、生殖激素水平、体液及细胞免疫水平的影响

Effect of minimally invasive surgery on the perioperative-related indicators,reproductive hormone,humoral and cellular immunity in patients with benign ovarian tumors

目的探讨腹腔镜手术治疗卵巢良性肿瘤的临床效果及对患者生殖激素、体液及细胞免疫功能的影响。方法选取2017年2月至2018年2月重庆市大足区人民医院诊治的118例良性卵巢肿瘤患者作为研究对象。采用随机数字表法分为微创组和传统组,每组各59例。微创组采用腹腔镜手术治疗,传统组采用传统开腹手术治疗,比较两组患者的围手术期相关指标、手术前后的血清雌激素(E2)、黄体生成素(LH)、促卵泡激素(FSH)、血清免疫球蛋白及外周血T淋巴细胞亚群。结果微创组患者的手术时间、术中出血量、术后肛门排气时间、住院时间均低于传统组,差异具有统计学意义(P<0.05);术前,两组患者的血清E2、LH、FSH水平差异无统计学意义(P>0.05);术后,微创组患者的血清E2高于传统组,差异具有统计学意义(P<0.05),LH、FSH水平低于传统组,差异具有统计学意义(P<0.05);术前,两组患者的CD3^+T细胞、CD4^+T细胞、CD8^+T细胞、CD4^+/CD8^+水平差异无统计学意义(P>0.05);术后,微创组患者的CD3^+T细胞、CD4^+T细胞、CD4^+/CD8^+水平高于传统组,差异具有统计学意义(P<0.05),CD8^+T细胞水平低于传统组,差异具有统计学意义(P<0.05);术前,两组患者的IgG、IgM、IgA水平差异无统计学意义(P>0.05);术后,微创组患者的IgG水平高于传统组(P<0.05),差异具有统计学意义,IgM、IgA水平与传统组差异无统计学意义(P>0.05)。结论腹腔镜手术治疗卵巢良性肿瘤具有创伤小、恢复快,对患者的生殖激素水平、免疫功能影响更小的特征。

Objective To investigate the clinical effect of laparoscopic surgery in the treatment of benign ovarian tumors and its effects on the reproductive hormones,humoral and cellular immunity.Methods A total of 118 patients with benign ovarian tumors admitted to Dazu District People′s Hospital from February 2017 to February 2018 were randomly divided into the minimally invasive group and the traditional group,each with 59 patients.The minimally invasive group was treated with laparoscopic surgery and the traditional group was treated with traditional laparotomy.Perioperative-related indicators,serum estrogen(E2),luteinizing hormone(LH),follicle stimulating hormone(FSH),serum immunoglobulin,and peripheral blood T lymphocyte subsets were compared between the two groups before and after surgery.Results The operation time,intraoperative blood loss,postoperative anal exhaust time,and hospital stay were lower in the minimally invasive group than those in the conventional group,with statistically significant differences(P<0.05).There was no statistically significant difference in serum E2,LH,and FSH levels between the two groups before surgery.After operation,the serum E2 of patients in the minimally invasive group was higher than that of the traditional group,with statistically significant differences(P<0.05),and the levels of LH and FSH were lower than those in the traditional group,with statistically significant differences(P<0.05).Before operation,there were no significant differences in CD3^+,CD4^+,CD8^+,and CD4^+/CD8^+levels between the two groups(P>0.05).After operation,the levels of CD3^+,CD4^+,CD4^+/CD8^+in the minimally invasive group were higher than those in the traditional group,with statistically significant differences(P<0.05),and the CD8^+level in the minimally invasive group was lower than that in the traditional group,with statistically significant differences(P<0.05).There was no significant difference in IgG,IgM,and IgA levels between the two groups before surgery(P>0.05).After operation,the IgG level in the minimally invasive group was higher than that in the traditional group,with statistically significant differences(P<0.05),and no significant difference was found in the IgM and IgA levels between the two groups(P>0.05).Conclusions Laparoscopic surgery for benign ovarian tumors has the characteristics of less trauma,faster recovery,less influence on reproductive hormone level and immune function.