中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2012年
15期
14-16
,共3页
腹腔镜检查%剖腹术%子宫切除术%免疫功能
腹腔鏡檢查%剖腹術%子宮切除術%免疫功能
복강경검사%부복술%자궁절제술%면역공능
Laparoscopy%Laparotomy%Hysterectomy%Immune function
目的 比较分析腹腔镜与开腹全子宫切除术对机体细胞免疫功能的影响.方法 选取行腹腔镜全子宫切除术患者28例(腹腔镜组)和开腹全子宫切除术患者28例(开腹组),比较两组手术效果及术前、术后T淋巴细胞亚群的变化情况.结果 腹腔镜组术中出血量、肛门排气时间、住院时间及术后并发症发生率均明显优于开腹组[(84.7±21.7) ml比(108.0±23.8) ml、(19.3±4.1)h比(23.8±3.8)h、(5.12±1.14)d比(7.81±2.27)d、7.1％(2/28)比17.9％(5/28),P＜0.05].腹腔镜组和开腹组术后1dCD4、CD8水平均较术前明显降低[腹腔镜组:(38.41±5.52)％比(40.72±6.46)％和(24.41±3.78)％比(26.33±4.17)％,开腹组:(38.41±4.97)％比(40.13±6.12)％和(24.41±6.32)％比(26.25±4.56)％,P＜0.05],但术后3d腹腔镜组CD4、CD8基本恢复至术前水平[(40.15±6.29)％、(27.23±5.12)％],术后3d开腹组CD4、CD8[(36.15±5.12)％、(23.15±4.87)％]与术前比较差异仍有统计学意义(P＜0.05).结论 腹腔镜全子宫切除术具有术中出血少、术后恢复快、并发症少等优点,且对机体细胞免疫功能的影响少,其疗效优于开腹全子宫切除术,值得推广和应用.
目的 比較分析腹腔鏡與開腹全子宮切除術對機體細胞免疫功能的影響.方法 選取行腹腔鏡全子宮切除術患者28例(腹腔鏡組)和開腹全子宮切除術患者28例(開腹組),比較兩組手術效果及術前、術後T淋巴細胞亞群的變化情況.結果 腹腔鏡組術中齣血量、肛門排氣時間、住院時間及術後併髮癥髮生率均明顯優于開腹組[(84.7±21.7) ml比(108.0±23.8) ml、(19.3±4.1)h比(23.8±3.8)h、(5.12±1.14)d比(7.81±2.27)d、7.1％(2/28)比17.9％(5/28),P＜0.05].腹腔鏡組和開腹組術後1dCD4、CD8水平均較術前明顯降低[腹腔鏡組:(38.41±5.52)％比(40.72±6.46)％和(24.41±3.78)％比(26.33±4.17)％,開腹組:(38.41±4.97)％比(40.13±6.12)％和(24.41±6.32)％比(26.25±4.56)％,P＜0.05],但術後3d腹腔鏡組CD4、CD8基本恢複至術前水平[(40.15±6.29)％、(27.23±5.12)％],術後3d開腹組CD4、CD8[(36.15±5.12)％、(23.15±4.87)％]與術前比較差異仍有統計學意義(P＜0.05).結論 腹腔鏡全子宮切除術具有術中齣血少、術後恢複快、併髮癥少等優點,且對機體細胞免疫功能的影響少,其療效優于開腹全子宮切除術,值得推廣和應用.
목적 비교분석복강경여개복전자궁절제술대궤체세포면역공능적영향.방법 선취행복강경전자궁절제술환자28례(복강경조)화개복전자궁절제술환자28례(개복조),비교량조수술효과급술전、술후T림파세포아군적변화정황.결과 복강경조술중출혈량、항문배기시간、주원시간급술후병발증발생솔균명현우우개복조[(84.7±21.7) ml비(108.0±23.8) ml、(19.3±4.1)h비(23.8±3.8)h、(5.12±1.14)d비(7.81±2.27)d、7.1％(2/28)비17.9％(5/28),P＜0.05].복강경조화개복조술후1dCD4、CD8수평균교술전명현강저[복강경조:(38.41±5.52)％비(40.72±6.46)％화(24.41±3.78)％비(26.33±4.17)％,개복조:(38.41±4.97)％비(40.13±6.12)％화(24.41±6.32)％비(26.25±4.56)％,P＜0.05],단술후3d복강경조CD4、CD8기본회복지술전수평[(40.15±6.29)％、(27.23±5.12)％],술후3d개복조CD4、CD8[(36.15±5.12)％、(23.15±4.87)％]여술전비교차이잉유통계학의의(P＜0.05).결론 복강경전자궁절제술구유술중출혈소、술후회복쾌、병발증소등우점,차대궤체세포면역공능적영향소,기료효우우개복전자궁절제술,치득추엄화응용.
Objective To compare the influence of laparoscopic and abdominal hysterectomy on cellular immune function. Methods There were 28 patients received laparoscopic hysterectomy (laparoscopic group) and 28 patients treated with abdominal hysterectomy (abdominal group).The surgical effects and the changes of preoperative and postoperative T lymphocyte subsets of two groups were compared.Results The intraoperative blood loss,anal exhaust time,hospital stay and postoperative morbidity of the laparoscopic group were significantly better than those of the laparotomy group[ (84.7 ± 21.7) ml vs.( 108.0 ± 23.8) ml,(19.3 ±4.1) h vs.(23.8 ±3.8) h,(5.12 ± 1.14) d vs.(7.81 ±2.27) d,7.1％ (2/28) vs.17.9％(5/28),P ＜ 0.05 ].CD4 and CD8 in the 1st day after operation of two groups were significantly lower than that before surgery respectively [ laparoscopic group:(38.41 ± 5.52)％ vs.( 40.72 ± 6.46)％,(24.41 ± 3.78 )％ vs.(26.33 ± 4.17)％ ;abdominal group:(38.41 ± 4.97)％ vs.(40.13 ± 6.12)％,(24.41 ±6.32)％ vs.(26.25 ±4.56)％,P ＜ 0.05 ]; but CD4 and CD8 in the 3rd day after operation in the laparoscopic group [ (40.15 ±6.29)％,(27.23 ± 5.12)％] almost returned to normal level before surgery,while CD4 and CD8 in the 3rd day after operation in the abdominal group [ (36.15 ± 5.12)％,(23.15 ± 4.87 )％] still had significant differences compared with that before surgery (P ＜ 0.05).Conclusions Laparoscopic hysterectomy with less blood loss,rapid postoperative recovery,fewer complications and less impact on cellular immune function,is superior to abdominal hysterectomy.Therefore,it deserves promotion and wide application.
