腹腔镜手术对子宫内膜异位症患者体液与细胞免疫功能、 妊娠率及术后尿失禁发生率的影响  

Effect of Laparoscopic Surgery on Humoral and Cellular Immune Function,Pregnancy Rate and Incidence of Postoperative UrinaryIncontinence in Patients with Endometriosis

作　　者：张强 翟艳红[2] 孙丽莎[2] ZHANG Qiang;ZHAI Yanhong;SUN Lisha(Department of Gynecology,Wuzhi County People’s Hospital,Jiaozuo 454950,China;Department of Gynecologic Oncology,Jiaozuo Second People’s Hospital,Jiaozuo 454950,China)

机构地区：[1]武陟县人民医院妇科,河南焦作454950 [2]焦作市第二人民医院妇瘤科,河南焦作454950

出　　处：《河南医学研究》2022年第17期3152-3154,共3页Henan Medical Research

摘　　要：目的探究腹腔镜手术对子宫内膜异位症(EMT)患者体液与细胞免疫功能、临床妊娠率及术后尿失禁发生率的影响。方法收集2019年2月至2021年1月武陟县人民医院收治的94例EMT患者,按手术方案分成腹腔镜组(n=47)、开腹组(n=47)。开腹组接受开腹手术治疗,腹腔镜组接受腹腔镜手术治疗。对比两组手术效果、手术前后性激素指标[雌二醇(E_(2))、卵泡刺激素(FSH)、黄体生成激素(LH)]水平、体液与细胞免疫功能指标[免疫球蛋白(IgG、IgM)、淋巴细胞亚群(CD3+、CD4+、CD4+/CD8+)]水平,随访1 a,统计两组临床妊娠率、尿失禁发生率。结果腹腔镜组总有效率较开腹组高(P<0.05);术后3个月腹腔镜组血清FSH、E_(2)、LH水平较开腹组低(P<0.05);术后3 d腹腔镜组血清IgM、IgG水平较开腹组低,CD3+、CD4+、CD4+/CD8+水平较开腹组高(P<0.05);随访1 a,腹腔镜组临床妊娠率较开腹组高,尿失禁发生率较开腹组低(P<0.05)。结论相较于开腹手术治疗EMT患者,应用腹腔镜手术治疗于提升手术效果、调节性激素水平、提高临床妊娠率、降低尿失禁发生率方面更具优势,且对机体体液、细胞免疫功能影响更小。Objective To investigate the effects of laparoscopic surgery on humoral and cellular immune function,clinical pregnancy rate and incidence of postoperative urinary incontinence in patients with endometriosis(EMT).Methods Ninety-four patients with EMT in Wuzhi County People’s Hospital from February 2019 to January 2021 were collected and divided into laparoscopic group(n=47)and open group(n=47)according to different surgical protocols.The open group received open surgical treatment and the laparoscopic group received laparoscopic surgical treatment.The surgical results,the levels of sex hormone indexes[estradiol(E_(2)),follicle-stimulating hormone(FSH),luteinizing hormone(LH)],the levels of humoral and cellular immune function indexes[immunoglobulins(IgG,IgM),lymphocyte subsets(CD3^(+),CD4^(+),CD4^(+)/CD8^(+))],and the clinical pregnancy rate and the incidence of urinary incontinence in the two groups were counted after 1 year follow-up.Results The overall effective rate was higher in the laparoscopic group than that in the open group(P<0.05).Serum FSH,E_(2) and LH levels were lower in the laparoscopic group compared with the open group after 3 months postoperatively(P<0.05).Serum IgM and IgG levels were lower in the laparoscopic group compared with the open group at 3 days postoperatively,and CD3+,CD4+and CD4+/CD8+levels were higher in the laparoscopic group compared with the open group(P<0.05).After 1 year follow-up,the clinical pregnancy rate was higher in the laparoscopic group than in the open group,and the incidence of urinary incontinence was lower in the laparoscopic group than in the open group(P<0.05).Conclusion Compared with open surgery for EMT patients,laparoscopic surgery is more advantageous in improving surgical outcomes,regulating sex hormone levels,improving clinical pregnancy rates,and reducing the incidence of urinary incontinence,and has less impact on body fluids,cellular immune function.

关 键 词：子宫内膜异位症 细胞免疫功能 腹腔镜手术 临床妊娠率 

分 类 号：R713.4[医药卫生—妇产科学]