腹腔镜下根治术对Ⅰ~Ⅱ期卵巢癌患者术后恢复、应激反应指标和卵巢功能的影响

Effects of laparoscopic radical surgery on postoperative recovery,stress response indicators,and ovarian function in patients with stage I-II ovarian cancer

目的探讨腹腔镜下根治术对Ⅰ~Ⅱ期卵巢癌患者术后恢复、应激反应指标和卵巢功能的影响。方法依据手术方法的不同将113例卵巢癌患者分为对照组(n=55)和观察组(n=58),对照组患者接受传统开腹治疗,观察组患者接受腹腔镜下根治术治疗。比较两组患者术后恢复指标、应激反应指标[皮质醇(Cor)、促肾上腺皮质激素(ACTH)和肾上腺素(E)]、卵巢功能指标[雌二醇(E2)、促卵泡激素(FSH)、黄体生成素(LH)]、免疫功能指标(CD3^(+)、CD4^(+)、CD8^(+))、生活质量[欧洲癌症研究与治疗组织生命质量测定量表(EORTC QLQ-C30)]、并发症发生情况和复发情况。结果观察组患者手术切口长度、术后住院时间、术后肛门排气时间均明显短于对照组,术中出血量明显少于对照组,手术时间显长于对照组,差异均有统计学意义(P﹤0.01)。术后7天,观察组患者Cor、ACTH、E、CD8^(+)水平均低于对照组,CD3^(+)、CD4^(+)水平均高于对照组,差异均有统计学意义(P﹤0.05)。术后3个月,观察组患者FSH、LH水平均高于对照组,E2水平低于对照组,差异均有统计学意义(P﹤0.05)。术后1、6、12个月,观察组患者EORTC QLQ-C30评分均高于本组干预前和对照组,差异均有统计学意义(P﹤0.05)。两组患者的并发症总发生率和复发率比较,差异均无统计学意义(P﹥0.05)。结论腹腔镜下根治术可有效提高Ⅰ~Ⅱ期卵巢癌患者的治疗效果,促进患者的术后恢复,减轻应激反应程度,改善免疫功能和卵巢功能,提高生活质量。

Objective To investigate the effects of laparoscopic radical surgery on postoperative recovery,stress re-sponse indicators,and ovarian function in patients with stage I-II ovarian cancer.Method A total of 113 ovarian cancer patients were divided into control group(n=55)and observation group(n=58)based on different surgical methods.Pa-tients in the control group received tradition open surgery,while patients in the observation group received laparoscopic radical surgery.The postoperative recovery indicators,stress response indicators[cortisol(Cor),adrenocorticotropic hor-mone(ACTH),epinephrine(E)],ovarian function indicators[estradiol(E2),follicle-stimulating hormone(FSH),luteiniz-ing hormone(LH)],immune function indicators(CD3+,CD4+,CD8+),quality of life[European Organization for Research and Treatment of Cancer quality of life questionnaire core 30(EORTC QLQ-C30)],incidence of complications,and recur-rence were compared between two groups.Result The length of surgical incision,postoperative hospitalization time and postoperative anal exhaust time in the observation group were significantly shorter than those in the control group,the in-traoperative bleeding volume was significantly less than that in the control group,and the surgical time was significantly longer than that in the control group,and the differences were statistically significant(P<0.01).Seven days after surgery,the levels of Cor,ACTH,E and CD8+in the observation group were lower than those in the control group,the levels of CD3+and CD4+were higher than those in the control group,and the differences were statistically significant(P<0.05).Three months after surgery,the levels of FSH and LH in the observation group were higher than those in the control group,while the level of E2 was lower than that in the control group,and the differences were statistically significant(P<0.05).At 1,6,and 12 months after surgery,the EORTC QLQ-C30 scores of the observation group were higher than those before surgery and the control group,and the differences were statistically significant(P<0.05).There were no statisti-cally significant differences in the total incidence of complications and recurrence rate between the two groups(P>0.05).Conclusion Laparoscopic radical surgery can effectively improve the treatment effect of stage I-II ovarian cancer patients,promote postoperative recovery,reduce stress response,improve immune function and ovarian function,and en-hance quality of life.