腹腔镜和开腹手术对卵巢良性肿瘤患者免疫功能相关指标的影响

发布时间：2018-04-25 20:28

本文选题：腹腔镜 + 开腹手术　；参考：《中国内镜杂志》2017年04期

【摘要】：目的探讨腹腔镜和开腹手术对卵巢良性肿瘤患者免疫功能相关指标的影响。方法以该院2015年1月-2016年1月收治的86例卵巢良性肿瘤患者为研究对象,按照随机数值表分组法将患者随机分为对照组和观察组,每组各43例。对照组进行传统开腹手术,观察组则进行腹腔镜手术。记录两组患者手术前及手术后免疫功能相关指标变化,分别测定手术前1天、术后第1天以及术后第3天的外周血白细胞数量(WBC)、中性粒细胞比率(NGR)、免疫球蛋白A(IgA)水平、免疫球蛋白G(IgG)水平、免疫球蛋白M(IgM)水平、C反应蛋白(CRP)含量以及T淋巴细胞亚群(CD3~+、CD4~+和CD3~+/CD4~+比值)分布情况,记录术后并发症发生率,并进一步进行统计学分析。结果术前两组患者IgA、IgG和IgM相比,差异无统计学意义(P0.05),术后两组仅IgG含量较术前明显下降,差异具有统计学意义(P0.05);对照组患者的WBC、NGR、CRP在术后第1和3天均较术前有明显上升,而观察组仅CRP较术前呈现增高状态;对照组与观察组的组间比较均有明显差异(P0.05);术前两组之间CD3~+、CD4~+和CD3~+/CD4~+比值无差异,差异无统计学意义(P0.05)。但术后两组均出现下降,且对照组下降更为明显,组间差异有统计学意义(P0.05);术后观察组并发症发生率为6.98%,对照组为16.28%。结论临床使用腹腔镜技术治疗卵巢良性肿瘤相对于传统开腹手术,能有效减少对患者免疫系统的影响,具有较高的安全性,有助于患者的恢复,值得推广应用。
[Abstract]:Objective to investigate the effect of laparoscopy and laparotomy on immune function in patients with benign ovarian tumors. Methods from January 2015 to January 2016, 86 patients with benign ovarian tumors were randomly divided into control group (n = 43) and observation group (n = 43). Traditional laparotomy was performed in the control group and laparoscopic surgery was performed in the observation group. The changes of immune function were recorded before and after operation. The levels of WBCU, neutrophil ratio and immunoglobulin A (IgA) in peripheral blood were measured 1 day before operation, 1 day after operation and 3 days after operation, respectively. The level of immunoglobulin G (IGG), the level of immunoglobulin (IgM) and the content of C-reactive protein (CRP), and the distribution of CD3 ~ + CD4 ~ and CD3- / CD4~ ratio of T lymphocyte subsets were recorded, and the incidence of postoperative complications was recorded and analyzed statistically. Results there was no significant difference between the two groups in IgA IgG and IgM before operation (P 0.05), but the content of IgG in the two groups was significantly lower than that before operation, and the difference was statistically significant (P 0.05), and that in the control group was significantly higher on the 1st and 3rd day after operation than that before operation. However, the CRP of the observation group was higher than that of the control group, the difference between the control group and the observation group was significant (P 0.05), and there was no significant difference between the two groups before operation in the ratio of CD3 ~ + CD4 ~ and CD3- / CD4 ~, there was no significant difference between the two groups (P 0.05). However, there was a decrease in the two groups after operation, and the decrease in the control group was more obvious, the difference between the two groups was statistically significant (P 0.05), the incidence of postoperative complications was 6.98 in the observation group and 16.28 in the control group. Conclusion Laparoscopic therapy for benign ovarian tumors can effectively reduce the influence on the immune system of patients with benign ovarian neoplasms compared with the traditional open surgery. It is safe and helpful to the recovery of patients. It is worth popularizing and applying.
【作者单位】：中南大学湘雅医院妇产科;
【分类号】：R737.31

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