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中文摘要: 目的 探讨腹腔镜囊肿剔除术对卵巢良性肿瘤患者免疫功能及卵巢功能的影响。方法 97例卵巢良性肿瘤患者根据术式不同分为腹腔镜组63例(行腹腔镜下卵巢囊肿剔除术)和开腹组34例(行开腹卵巢囊肿剔除术)，记录两组手术情况及不良反应发生情况，观察手术前后患者免疫功能及卵巢功能的变化。结果 与开腹组比较，腹腔镜组手术时间、肠功能恢复时间和住院时间明显缩短(P＜0.01)，术中出血量明显减少(P＜0.05)。术后1 d，两组IgG水平较术前明显降低，腹腔镜组术后3 d恢复正常，开腹组略有升高，但仍低于腹腔镜组(P＜0.05)；术前及术后1、3 d，腹腔镜组CD3+、CD4+、CD8+、CD4+/CD8+指标未见明显变化(P＞0.05)，开腹组术后1 d明显降低，术后3 d除CD3+恢复正常外，其余各指标略有升高，但仍低于腹腔镜组(P＜0.05或P＜0.01)。术后3个月及1年，两组性激素水平逐渐恢复正常，但腹腔镜组恢复程度明显优于开腹组(P＜0.01)；术后1、3个月及1年，腹腔镜组收缩期峰值流速(PSV)较术前明显增加，阻力指数(RI)明显降低(P＜0.01)，而对照组未见明显变化(P＞0.05)。两组术后不良反应比较差异有统计学意义(P＜0.05)。结论 腹腔镜囊肿剔除术对卵巢良性肿瘤患者免疫功能、近远期卵巢功能的损害均小于开腹囊肿剔除术，有利于患者的术后恢复。
Abstract:OBJECTIVE To explore the influence of laparoscopic cystectomy on immunity and ovarian functions of patients with benign ovarian tumor.METHODS A total of 97 patients with benign ovarian tumor were divided into laparoscopy group (n=63) treated with laparoscopic cystectomy and laparotomy group (n=34) treated with laparotomy cystectomy based on different surgical methods. Surgical conditions and occurrence rates of adverse reactions were recorded in both groups, and the changes of patients’ immunity and ovarian functions were observed before and after surgery. RESULTS Compared with laparotomy group, laparoscopy group was markedly shorter in surgical duration, intestinal function recovery time and the length of hospital stays (P＜0.01), and notably less in intra-operative hemorrhagic volume (P＜0.05). On postoperative d1, IgG level was decreased evidently in both groups before surgery, which was recovered to normal on postoperative d3 in laparoscopy group, and was increased slightly in laparotomy group which was still apparently lower than that in laparoscopy group (P＜0.05). The levels of CD3+, CD4+, CD8+ and CD4+/CD8+ were not changed in laparoscopy group before surgery and on postoperative d 1 and 3 (P＞0.05), but were decreased on postoperative d1 in laparotomy group. Except that CD3+ was restored to normal, other indexes were increased slightly on postoperative d3 in laparotomy group, but they were still markedly lower than those in laparoscopy group (P＜0.05 or P＜0.01). In postoperative month 3 and year 1, the levels of sexual hormones were restored to normal in both groups, but the restoration degree was significantly better in laparoscopy group than that in laparotomy group (P＜0.01). In postoperative month 1 and 3 as well as year 1,the peak systolic velocity (PSV) was increased and resistance index (RI) was decreased prominently in laparoscopy group (P＜0.01), but the two indexes were not changed in laparotomy group (P＞0.05). There was insignificant difference between two groups in the occurrence rates of postoperative adverse reactions (P＜0.05). CONCLUSION Laparoscopic cystectomy has less influence than laparotomy cystectomy on the immunity and short- and long-term ovarian functions of patients with benign ovarian tumor, and is beneficial to patients’ postoperative recovery.
文章编号：3201805014 中图分类号：R1-9 文献标志码：
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| 作者 | 单位 |
| 范颖芳①，胡予婷① |
| Author Name | Affiliation |
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