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

Effect of laparoscopy and laparotomy surgery on immune function related indicators in ovarian benign tumor patients

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（P >0.05），术后两组仅IgG含量较术前明显下降，差异具有统计学意义（P <0.05）；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（P <0.05）；术前两组之间CD3+、CD4+和CD3+ /CD4+比值无差异，差异无统计学意义（P >0.05）。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（P <0.05）；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 explore the effect of laparoscopy and laparotomy surgery on immune function related indicators in ovarian benign tumor patients.?Methods?From January 2015 to January 2016, 86 cases of ovarian benign tumor patients were set as study objects. All the patients were randomly divided into control group and observation group, 43 cases in each. Patients in control group were given traditional laparotomy surgery, while patients in observation group were given laparoscopic surgery. The changes of immune function related indexes before and after operation were recorded, before operation, day 1 and day 3 postoperative, number of peripheral white blood cells (WBC), neutrophil ratio (NGR), immunoglobulin (IgA, IgG, IgM) levels, C reactive protein (CRP) content and the distribution of T lymphocyte subsets (CD3+, CD4+ and CD3+/CD4+ ratio) distribution were respectively determined, and the incidence of postoperative complications was recorded, and were further statistical analyzed.?Results?There was no significant difference in immunoglobulin IgA, IgG and IgM between the two groups before operation (P > 0.05). Postoperative, only the IgG content of the two groups was significantly lower than that before the operation (P < 0.05 ); The levels of WBC, NGR and CRP in the control group patients in the first day and the third day after surgery were significantly increased compared with preoperative period, while CRP in the observation group was higher than that before the operation, there was significant difference between the two groups (P < 0.05). There was no significant difference in CD3+, CD4+ and CD3+/CD4+ ratios between the two groups before operation (P > 0.05), the difference between the two groups was significant (P < 0.05). The complication rate of the observation group after operation was 6.98%, the control group was 16.28%.?Conclusion?Clinical use of laparoscopic treatment of benign ovarian tumors relative to the traditional laparotomy can effectively reduce the immune system of patients with immune function, with high safety, contribute to the recovery of patients, it is worthy of clinical promoting.