经阴道自然腔道内镜手术对全子宫切除术患者红细胞免疫和泌尿功能的影响  

Effect of erythrocyte immunity and urinary function in patients undergoing total hysterectomy by transvaginal natural orifice transluminal endoscopic sugery

作　　者：孙滨州 黄立 朱静 Sun Binzhou;Huang Li;Zhu Jing(Department of Gynecology,Qinhuangdao Maternal and Child Health Hospital,Hebei,Qinhuangdao 066000,China)

机构地区：[1]秦皇岛市妇幼保健院妇科,河北秦皇岛066000

出　　处：《发育医学电子杂志》2023年第3期181-186,共6页Journal of Developmental Medicine (Electronic Version)

基　　金：河北省秦皇岛市卫生健康委(202004A027)。

摘　　要：目的探讨经阴道自然腔道内镜手术(transvaginal natural orifice transluminal endoscopic sugery,vNOTES)对全子宫切除术患者红细胞免疫和泌尿功能的影响。方法选取2019年1月至2020年12月在秦皇岛市妇幼保健院拟行全子宫切除术的患者136例,采用随机数字表法将其分为对照组和观察组,每组68例。对照组采取经脐单孔腹腔镜手术(transumbilical laparoendoscopic single-site surgery,TU-LESS),观察组采取vNOTES。统计围术期指标、并发症,比较两组手术前后红细胞免疫黏附促进因子(forming enhancement rosetterate,FEER)、白细胞分化抗原59(cluster of differentiation 59,CD59)、协同肿瘤红细胞花环素(associated tumor erythrocyte rossette,ATER)、促黄体生成素(luteinizing hormone,LH)、卵泡刺激素(follicular stimulating hormone,FSH)、最大尿流率(maximum urine flow rate,Qmax)、残余尿量(residual urine volume,RUV)、膀胱顺应性、盆底功能(pelvic floor impact questionnake,short form 7,PFIQ-7)。统计学方法采用t检验、χ^(2)检验、Fisher确切概率法和重复测量方差分析。结果观察组肛门排气时间、排便时间短于对照组[(9.3±1.3)、(20.2±2.7)h与(15.6±1.2)、(30.3±3.6)h,t=28.876、18.572,P值均<0.001];观察组术后24 h视觉模拟评分(visual analogue scale,VAS)低于对照组[(2.9±0.4)与(3.9±0.4)分,t=14.500,P<0.001)];术后3 d观察组血清ATER、FEER、CD59水平高于对照组[(50.4±2.1)%、(54.7±3.1)%、(4.9±0.6)%与(46.6±2.7)%、(50.4±3.4)%、(4.0±0.7)%,F组间=13.405、9.334、11.271,P值均<0.05)。术后1、3个月观察组Qmax高于对照组[(15.5±1.3)、(18.0±1.4)ml/s与(13.4±1.4)、(16.7±1.4)ml/s,RUV低于对照组[(15.7±1.3)、(10.1±0.6)ml与(18.9±2.1)、(12.7±0.9)ml,F交互=15.182,P<0.05],膀胱顺应性低于对照组[(7.8±0.6)、(5.0±0.4)与(9.1±0.6)、(5.9±0.5),F交互=9.532,P<0.05],PFIQ-7分低于对照组[(1.6±0.2)、(1.1±0.1)分与(1.9±0.2)、(1.3±0.2)分,F交互=11.332,P<0.05];两组FSH、LH、并发Objective To investigate the effect of transvaginal natural orifice transluminal endoscopic sugery(vNOTES)on erythrocyte immunity and urinary function in patients undergoing total hysterectomy.Method A total of 136 patients undergoing total hysterectomy in Qinhuangdao Maternal and Child Health Hospital from January 2019 to December 2020 were selected and randomly divided into control group and observation group with 68 cases in each group.The control group underwent transumbilical laparoendoscopic single-site surgery(TU-LESS),and the observation group underwent vNOTES.Perioperative indexes and complications of the two groups were analyzed.Erythrocyte immunity before and after surgery[forming enhancement rosetterate(FEER),cluster of differentiation 59(CD59),associated tumor erythrocyte rosette(ATER)],[luteinizing hormone(LH),follicular stimulating hormone(FSH)],[maximum urine flow rate(Qmax),residual urine volume(RUV),bladder compliance],Pelvic floor impact questionnake,short form 7(PFIQ-7),which were compared between the two groups.t test,χ^(2)test,fisher exact probability method and repeated measure of variance were used for statistical analysis were used as statistical methods.Result The anal exhaust time and defecation time of the observation group were less than those of the control group[(9.3±1.3),(20.2±2.7)h and(15.6±1.2),(30.3±3.6)h,t=28.876,18.572,all P<0.001].The 24 h visual analogue scale(VAS)of the observation group was lower than that of the control group[(2.9±0.4)vs(3.9±0.4)points,t=14.500,P<0.001].The serum levels of ATER,FEER and CD59 in the observation group were higher than those in the control group at 3 days after operation[(50.4±2.1)%,(54.7±3.1)%,(4.9±0.6)%and(46.6±2.7)%,(50.4±3.4)%,(4.0±0.7)%,Fintergroup=13.405,9.334,11.271,all P<0.05).Qmax of the observation group was higher than that of the control group[(15.5±1.3),(18.0±1.4)ml/s vs(13.4±1.4),(16.7±1.4)ml/s;RUV was lower than that of control group[(15.7±1.3),(10.1±0.6)ml vs(18.9±2.1),(12.7±0.9)ml,Finteraction=15.182,P<0

关 键 词：全子宫切除术 经阴道自然腔道内镜手术 经脐单孔腹腔镜手术 红细胞免疫 泌尿功能 

分 类 号：R713.4[医药卫生—妇产科学]