良性卵巢肿瘤患者行腹腔镜下手术治疗对免疫指标、炎性介质及性激素水平的影响  

Effects of laparoscopic surgery on immune parameters and FSH,LH,E_2 levels in patients with ovarian benign tumor

作　　者：魏海波[1] 郭静[1] 林林[1] 李丽[1] 韩雪[1] 金玲[1] 

机构地区：[1]辽宁省铁岭市中心医院妇产科,112000

出　　处：《疑难病杂志》2017年第6期605-609,共5页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的探讨良性卵巢肿瘤患者行腹腔镜下手术治疗对免疫指标(体液免疫和细胞免疫)、炎性介质及卵泡刺激素(FSH)、黄体生成激素(LH)、雌二醇(E_2)水平的影响。方法选取2015年3月—2016年3月铁岭市中心医院妇产科收治的96例良性卵巢肿瘤患者,按照手术方式的不同分为观察组和对照组各48例。观察组采用腹腔镜肿瘤切除术,对照组采用传统开腹手术治疗。比较2组患者手术时间、术中出血量、胃肠道功能恢复时间、抗生素使用时间及住院时间;分别于手术前后检测IgG、IgA、IgM、C3、C4、CD4^+、CD8^+、IL-2、IL-6、IL-10、FSH、LH、E_2,并计算CD4^+/CD8^+;术后随访1~6个月记录不良反应。结果观察组术中出血量、胃肠道功能恢复时间、抗生素使用时间、住院时间明显少/短于对照组(t=27.953、24.133、18.763、17.214,P<0.01),而2组患者手术时间无明显差异(t=0.741,P>0.05);观察组IgG、C3、CD4^+、CD8^+、CD4^+/CD8^+、IL-2、E_2降低幅度明显低于对照组(t=4.478、2.967、5.829、3.402、8.937、6.497、10.427,P<0.01),IL-6、IL-10、FSH、LH升高幅度显著低于对照组(t=5.108、4.505、13.689、28.293,P<0.01);观察组搏动指数(PI)、阻力指数(RI)明显低于对照组,收缩期峰值流速度(PSV)显著高于对照组(t=4.032、7.745、3.202,P<0.01);2组患者术后随访1~6个月,观察组月经紊乱、经量减少、经期延长、卵巢功能减退发生率明显低于对照组,差异具有统计学意义(χ~2=4.501、8.675、5.879、5.073,P<0.05)。结论腹腔镜下手术治疗良性卵巢肿瘤患者对机体免疫功能、卵巢功能影响较小,安全性好,值得临床推广应用。Objective To investigate the effects of laparoscopic surgery on immune parameters and FSH, LH, E2 levels in patients with ovarian benign tumor.Methods Ninty-six cases of patients with ovarian benign tumor were selected, who were treated in hospital from March 2015 to March 2016, and they were divided into the observation group （48 cases） and control group （48 cases）.The patients of observation group were treated with laparoscopic tumor resection, while the patients of control group were treated with traditional open surgery.The operation time, intraoperative blood loss, gastrointestinal function recovery time, antibiotic use time, hospital stay and changes of the levels of IgG, IgA, IgM, C3, C4, CD4＋, CD8＋, IL-2, IL-6, IL-10, FSH, LH, E2, CD4＋/CD8＋ of the two groups were compared.Results The intraoperative blood loss, gastrointestinal function recovery time, antibiotic use time and hospital stay of the observation group were significantly lower than those of the control group （t=27.953,t=24.133,t=18.763,t=17.214,P=0.000,P=0.000,P=0.000,P=0.00）, but there was no significant difference in the operation time between the two groups （t=0.741,P=0.230）;the reduced amplitude of IgG, C3, CD4＋, CD8＋, CD4＋/CD8＋, IL-2, E2 and increased amplitude of IL-6, IL-10, FSH, LH of the observation group were significantly lower than those of the control group （t=4.478,t=2.967,t=5.829,t=3.402,t=8.937,t=6.497,t=10.427;P=0.000,P=0.002,P=0.000,P=0.000,P=0.000,P=0.000,P=0.000）;PI, RI of the observation group were significantly lower than those of the control group （t=4.032,t=7.745,P=0.000,P=0.000）, and PSV of the observation group were significantly higher than those of the control group（t=3.202,P=0.000）;there were menstrual disorders, menstrual reduction, prolonged menstruation, ovarian dysfunction occurred in both two groups in the follow up of 1 to 6 months, and the incidence of the observation group were significantly lower than the control group （χ2=4.501,χ2=8.675,χ2=5.879,χ2=5.073;P=0

关 键 词：良性卵巢肿瘤 腹腔镜 免疫指标 炎性介质 性激素 

分 类 号：R737.31[医药卫生—肿瘤]