经阴道子宫肌瘤剔除术对子宫肌瘤患者免疫功能及并发症的影响

The effect of transvaginal myomectomy on the immune function and complications of patients with uterine myoma

目的探讨腹腔镜与经阴道子宫肌瘤剔除术对患者免疫功能及近期妊娠成功率的影响。方法选取2017年2月至2018年12月本院收治的80例子宫肌瘤患者,按照治疗方法分为对照组与观察组,各40例。两组均实施子宫肌瘤剔除术治疗,对照组在腹腔镜下进行治疗,观察组采用经阴道方式进行治疗。比较两组手术相关指标、并发症发生率、手术前后两组免疫功能。结果观察组手术时间、住院时间[(80.23±2.96)min、(4.53±1.12)d]均短于对照组[(97.45±11.35)min、(7.23±1.75)d],术中出血量[(131.26±24.16)ml]少于对照组[(185.69±30.12)ml],差异有统计学意义(t=9.285、8.915、8.219,P均<0.001);术后1 d,两组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)均低于术前,但观察组[(57.89±3.15)%、(33.61±3.06)%、(1.40±0.21)]均高于对照组[(53.28±2.51)%、(29.71±2.06)%、(1.21±0.25)],差异有统计学意义(t=7.239、6.687、3.681,P均<0.001);观察组并发症总发生率(5.00%)与对照组(10.00%)比较差异无统计学意义。结论经阴道子宫肌瘤剔除术治疗有助于缩短子宫肌瘤患者手术与住院时间,减少术中出血量,对患者免疫功能影响较小,安全性较高。

Objective To investigate the effects of laparoscopy and transvaginal myomectomy on the immune function and the success rate of recent pregnancy.Methods 80 patients with uterine fibroids admitted to our hospital from February 2017 to December 2018 were selected and they were divided into control group and observation group according to the treatment method,with 40 cases in each group.Both groups were treated with myomectomy,the control group was treated with laparoscopy,and the observation group was treated with transvaginal treatment.The operation-related indicators,the incidence of complications,and the immune function between the two groups before and after the operation were compared.Results The operation time and hospital stay[(80.23±2.96)min,(4.53±1.12)d]of the observation group were shorter than those of the control group[(97.45±11.35)min,(7.23±1.75)d],and the amount of intraoperative blood loss[(131.26±24.16)ml]was less than the control group[(185.69±30.12)ml],the difference was statistically significant(t=9.285,8.915,8.219,all P<0.001);1 day after operation,the two groups of CD3^(+),CD4^(+),CD4^(+)/CD8^(+)were lower than before operation,but the observation group[(57.89±3.15)%,(33.61±3.06)%,(1.40±0.21)]were higher than the control group[(53.28±2.51)%,(29.71±2.06)%,(1.21±0.25)],the difference was statistically significant(t=7.239,6.687,3.681,all P<0.001);the total incidence of complications in the observation group(5.00%)and the control group(10.00%)had no difference statistically significant.Conclusion Transvaginal myomectomy treatment can help shorten the operation and hospitalization time,reduce the amount of intraoperative blood loss,and have a smaller impact on the patient’s immune function and higher safety.