目的：探讨腹腔镜下与开腹手术治疗盆腔炎症包块对机体细胞免疫功能及术后恢复时间的影响并探讨它们之间的关系.方法：2008年1月至2011年12月在青岛妇女儿童医院取56例盆腔炎包块手术患者术前、术后2h、术后24h和术后72h的静脉血标本(腹腔镜手术组32例(腹腔镜组)和开腹剔除术24例(开腹组).①流式细胞术(flow cytometry,FCM)测定 T细胞亚群CD3、CD4和 CD8,对两组各指标的测定值进行比较,同时测定Th1、Th2细胞数量,统计两组之间各亚群以及Th1、Th2和、Th1/Th2比值的差异；②酶标法(ELISA)测定血清白介素(IL-18、IL-10水平,统计两组之间的差异；③术后恢复情况：排气时间、体温恢复到正常时间、血象恢复时间、住院时间等.结果：腹腔镜组T淋巴细胞亚群手术前后差异均无显著性；开腹组术后1 d时 CD3, CD4,CD8与术前比较均明显降低,术后3d时有所回升,但仍低于术前水平；两组比较,开腹组术后 CD3,CD4,CD8降低更为明显；两组术后2h均出现 Th1/Th2细胞平衡向 Th2反应转换,Th1细胞、Th1/Th2比值、IL-18下降(腹腔镜组：t＝2．238,P＜0．05；t＝7．15,P＜0．01；t＝6．98,P＜0．01；开腹组：t＝9．45,P＜0．01；t＝8．56,P＜0．01；t＝10．17,P＜0．01),而 Th2细胞、抗炎因子 IL-10上升(腹腔镜组：t＝7．35,P＜0．01；t＝8．87,P＜0．01；开腹组：t＝6．53,P＜0．01；t＝7．18,P＜0．01)但腹腔镜组术后24hTh1、Th2细胞数、Th1/Th2比值、IL-18、IL-10各项指标即恢复(t＝1．82,P＞0．05；t＝1．38,P＞0．05；t＝1．72,P＞0．05；t＝1．78,P＞0．05；t＝1．89,P＞0．05),而开腹组24h各项指标的变化与术后2h类似,并持续至术后48h.结论：盆腔炎手术后细胞免疫功能紊乱可能参与术后的恢复；腹腔镜下盆腔炎性包块切除术组T细胞亚群影响程度小,且Th1/Th2细胞平衡恢复快,对机体的细胞免疫影响小,术后恢复快.
目的：探討腹腔鏡下與開腹手術治療盆腔炎癥包塊對機體細胞免疫功能及術後恢複時間的影響併探討它們之間的關繫.方法：2008年1月至2011年12月在青島婦女兒童醫院取56例盆腔炎包塊手術患者術前、術後2h、術後24h和術後72h的靜脈血標本(腹腔鏡手術組32例(腹腔鏡組)和開腹剔除術24例(開腹組).①流式細胞術(flow cytometry,FCM)測定 T細胞亞群CD3、CD4和 CD8,對兩組各指標的測定值進行比較,同時測定Th1、Th2細胞數量,統計兩組之間各亞群以及Th1、Th2和、Th1/Th2比值的差異；②酶標法(ELISA)測定血清白介素(IL-18、IL-10水平,統計兩組之間的差異；③術後恢複情況：排氣時間、體溫恢複到正常時間、血象恢複時間、住院時間等.結果：腹腔鏡組T淋巴細胞亞群手術前後差異均無顯著性；開腹組術後1 d時 CD3, CD4,CD8與術前比較均明顯降低,術後3d時有所迴升,但仍低于術前水平；兩組比較,開腹組術後 CD3,CD4,CD8降低更為明顯；兩組術後2h均齣現 Th1/Th2細胞平衡嚮 Th2反應轉換,Th1細胞、Th1/Th2比值、IL-18下降(腹腔鏡組：t＝2．238,P＜0．05；t＝7．15,P＜0．01；t＝6．98,P＜0．01；開腹組：t＝9．45,P＜0．01；t＝8．56,P＜0．01；t＝10．17,P＜0．01),而 Th2細胞、抗炎因子 IL-10上升(腹腔鏡組：t＝7．35,P＜0．01；t＝8．87,P＜0．01；開腹組：t＝6．53,P＜0．01；t＝7．18,P＜0．01)但腹腔鏡組術後24hTh1、Th2細胞數、Th1/Th2比值、IL-18、IL-10各項指標即恢複(t＝1．82,P＞0．05；t＝1．38,P＞0．05；t＝1．72,P＞0．05；t＝1．78,P＞0．05；t＝1．89,P＞0．05),而開腹組24h各項指標的變化與術後2h類似,併持續至術後48h.結論：盆腔炎手術後細胞免疫功能紊亂可能參與術後的恢複；腹腔鏡下盆腔炎性包塊切除術組T細胞亞群影響程度小,且Th1/Th2細胞平衡恢複快,對機體的細胞免疫影響小,術後恢複快.
목적：탐토복강경하여개복수술치료분강염증포괴대궤체세포면역공능급술후회복시간적영향병탐토타문지간적관계.방법：2008년1월지2011년12월재청도부녀인동의원취56례분강염포괴수술환자술전、술후2h、술후24h화술후72h적정맥혈표본(복강경수술조32례(복강경조)화개복척제술24례(개복조).①류식세포술(flow cytometry,FCM)측정 T세포아군CD3、CD4화 CD8,대량조각지표적측정치진행비교,동시측정Th1、Th2세포수량,통계량조지간각아군이급Th1、Th2화、Th1/Th2비치적차이；②매표법(ELISA)측정혈청백개소(IL-18、IL-10수평,통계량조지간적차이；③술후회복정황：배기시간、체온회복도정상시간、혈상회복시간、주원시간등.결과：복강경조T림파세포아군수술전후차이균무현저성；개복조술후1 d시 CD3, CD4,CD8여술전비교균명현강저,술후3d시유소회승,단잉저우술전수평；량조비교,개복조술후 CD3,CD4,CD8강저경위명현；량조술후2h균출현 Th1/Th2세포평형향 Th2반응전환,Th1세포、Th1/Th2비치、IL-18하강(복강경조：t＝2．238,P＜0．05；t＝7．15,P＜0．01；t＝6．98,P＜0．01；개복조：t＝9．45,P＜0．01；t＝8．56,P＜0．01；t＝10．17,P＜0．01),이 Th2세포、항염인자 IL-10상승(복강경조：t＝7．35,P＜0．01；t＝8．87,P＜0．01；개복조：t＝6．53,P＜0．01；t＝7．18,P＜0．01)단복강경조술후24hTh1、Th2세포수、Th1/Th2비치、IL-18、IL-10각항지표즉회복(t＝1．82,P＞0．05；t＝1．38,P＞0．05；t＝1．72,P＞0．05；t＝1．78,P＞0．05；t＝1．89,P＞0．05),이개복조24h각항지표적변화여술후2h유사,병지속지술후48h.결론：분강염수술후세포면역공능문란가능삼여술후적회복；복강경하분강염성포괴절제술조T세포아군영향정도소,차Th1/Th2세포평형회복쾌,대궤체적세포면역영향소,술후회복쾌.
Objective:To examine cellular immune function and postoperative recovery time of utilization laparoscopy operation in pelvic inflammation mass and to investigate the relationship between them.Methods:Venous blood preparation were col ected from patients with performed with pelvic inflammation mass during operation treatment.32 patients with were performed with laparoscopy,the left with abdominal operation.Subgroup of T lymphocyte include of CD3、CD4 and CD8 was examined by flow cytometer analyzed with own control,meanwhile determination of Th1 ,Th2 cells.Statistics between the two groups,as wel as various subgroup Th1,Th2 and,Th1/Th2 ratio dif erences.ELISA method for measuring serum IL-18,IL-10 level,statistical dif erences between the two groups.Postoperative recovery:exhaust time,body temperature returned to normal time,recovery time Hemogram,length of stay,etc.Result:Laparoscopic group T-lymphocyte subsets before and after surgery There was no significant dif erence;Laparotomy group one day after CD3,CD4,CD8 compared with the preoperative were significantly lower after 3 days recovery,but stil lower than the preoperative level;Two groups of comparison,the open group were CD3,CD4,CD8 reduce the more obvious;The two groups after two hours both Th1/Th2 balance to Th2 cells in response to the conversion,Th1 cells,Th1/Th2 ratio,IL-18 decreased(Laparoscopic group:t=2.238,P<0.05;t=7.15,P<0.01;t=6.98,P<0.01;laparotomy group:t=9.45,P<0.01;t=8.56,P<0.01;t=10.17,P<0.01)And Th2 cells,anti-inflammatory cytokines IL-10 increased.(Laparoscopic group:t=7.35,P<0.01;t=8.87,P<0.01;laparotomy group:t=6.53,P<0.01;t=7.18,P<0.01).But the laparoscopic group after 24 hours of the indicators that is restored(t=1.82,P>0.05;t=1.38,P>0.05;t=1.72,P>0.05;t=1.78,P>0.05;t=1.89,P>0.05),and open group of indicators changes and two hours after a similar,and continued until after 48 hours.Conclusion:Pelvic inflammatory disease after cellular immune dysfunction may be involved in post-operative recovery;Pelvic Inflammatory Mass laparoscopic resection group T-cellsubsets impact of smal ,and the Th1/Th2 cellbalance and rapid recovery of the body's cellular immune ef ects of smal ,faster postoperative recovery.
