腹腔镜下卵巢囊肿剥除术中不同止血方法对卵巢良性囊肿患者卵巢功能、应激反应以及T细胞亚群的影响

Effects of Different Hemostasis Methods on Ovarian Function,Stress Response and T Cell Subsets in Patients with Benign Ovarian Cysts During Laparoscopic Ovarian Cyst Removal

目的探讨腹腔镜下卵巢囊肿剥除术中不同止血方法对卵巢良性囊肿患者应激反应、卵巢功能以及T细胞亚群的影响。方法:选取我院于2017年1月~2019年1月间接收的80例卵巢良性囊肿患者,根据随机数字表法分为A组(n=40)和B组(n=40)A组患者术中采用双极电凝止血,B组患者术中采用缝合止血,比较两组患者卵巢功能[卵泡刺激素(FSH)、雌二醇(E2)以及黄体生成素(LH)]、应激反应[促肾上腺皮质激素(ACTH)、去甲肾上腺素(NE)以及皮质醇(Cor)]、T细胞亚群及并发症发生率。结果:两组患者术后3个月FSH、LH均升高,但B组低于A组(P<0.05);E2降低,但B组高于A组(P<0.05)。两组患者术后3个月ACTH、NE、Cor均升高,但B组低于A组(P<0.05)。两组患者术后3个月CD3^(+)、CD4^(+)/CD8^(+)、CD4^(+)均降低但B组高于A组(P<0.05);CD8^(+)升高,但B组低于A组(P<0.05)。两组术后并发症发生率比较差异无统计学意义(P>0.05)。结论:与双极电凝止血相比,腹腔镜下卵巢囊肿剥除术中采用缝合止血可减轻卵巢功能损害,降低应激反应,减轻免疫抑制,且不增加并发症发生率。

Objective:To investigate the effect of different hemostasis methods on ovarian function,stress response and T cell subsets in patients with benign ovarian cysts during laparoscopic ovarian cyst removal.Methods:From January 2017 to January 2019,80 patients with benign ovarian cysts in our hospital were selected,they were divided into group A(n=40)and group B(n=40).In group A,bipolar electrocoagulation was used for hemostasis,while in group B,suture was used for hemostasis.The ovarian function[follicle stimulating hormone(FSH),estradiol(E2)and luteinizing hormone(LH)],stress response[adrenocorticotropic hormone(ACTH),norepinephrine(NE)and cortisol(Cor)],T cell subsets and complications were compared between the two groups.Results:FSH and LH increased in both groups 3 months after operation,but group B was lower than group A(P<0.05).E2 decreased,but group B was higher than group A(P<0.05).ACTH,NE and Cor were all increased in the two groups 3 months after operation,but the levels in group B were lower than those in group A(P<0.05).CD3^(+),CD4^(+)/CD8^(+)and CD4^(+)decreased in the two groups 3 months after operation,but group B was higher than group A(P<0.05);CD8^(+)increased,but group B was lower than group A(P<0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).Conclusion:Compared with bipolar electrocoagulation hemostasis,suture hemostasis during laparoscopic ovarian cyst removal can reduce ovarian function damage,reduce stress response,and reduce immunosuppression,without increasing the incidence of complications.