腹腔镜及开腹子宫切除术对患者机体免疫功能的影响

胡兴焕1，邹伟2

（1. 陕西安康汉滨区第一医院妇产科，陕西 安康，725000；2.西京医院妇产科，陕西 西安，713200）

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摘要：

目的 比较分析腹腔镜及开腹子宫切除术对患者免疫功能的影响。方法 选择我院收治的需行子宫切除患者150例为研究对象，分为腹腔镜组和传统组，分别采用腹腔镜子宫切除术和开腹子宫切除术，比较两组患者手术前后IL-6 和TNF-α水平、外周血T 淋巴细胞亚群及NK细胞情况。结果 术后24 h，两组患者IL-6 和TNF-α水平均明显高于术前（P<0.05），且腹腔镜组IL-6 和TNF-α水平均低于传统组（P<0.05）；术后72 h，两组患者IL-6 和TNF-α水平均明显低于术后24 h，且腹腔镜组IL-6 和TNF-α水平均低于传统组（P<0.05）；腹腔镜组患者手术前、术后24 h、术后72 h CD3+、CD4+、CD8+、CD4/CD8 及CD16+比较差异均无统计学意义（P>0.05）；传统组患者术后24 h，CD3+、CD4+、CD8+明显低于手术前（P<0.05）；传统组术后 72 h，CD3+、CD4+、CD8+明显高于术后24 h（P<0.05）。结论 与传统开腹子宫切除术比较，腹腔镜子宫切除术对免疫功能的影响较小。

关键词：腹腔镜；开腹子宫切除术；免疫功能

中图分类号：R713.42文献标志码：A文章编号：2096-1413(2017)01-0057-02

Effect of laparoscopic and open hysterectomy on immune function
HU Xing-huan 1, ZOU Wei 2
(1. Department of Obstetrics and Gynecology, the First Hospital of Hanbin District of Ankang, Ankang 725000;
2. Department of Obstetrics and Gynecology, Xijing Hospital, Xi an 713200, China)

ABSTRACT: Objective To compare the effect of laparoscopic and open hysterectomy on immune function. Methods One hundred and fifty cases of patients with hysterectomy were selected. All the patients were divided into the laparoscopic group and traditional group which used laparoscopic hysterectomy and open hysterectomy separately. The changes of IL-6 and TNF-α, peripheral blood, T lymphocyte subsets and NK cell were compared between pre-operation and post-operation. Results 24 h after operation, the levels of IL-6 and TNF-α of two groups were obviously higher than pre-operation, and the levels of IL-6 and TNF-α in laparoscopic group were lower than those in the traditional group (P<0.05). 72 h after operation, the levels of IL-6 and TNF-α of two groups were obviously lower than 24 h after operation, and the levels of IL-6 and TNF-α in laparoscopic group were lower than those in the traditional group (P<0.05). In laparoscopic group, there were no significant differences in CD3+、CD4+、CD8+、CD4/CD8 and CD16+ among pre-operation, 24 h after operation and 72 h after operation (P>0.05). In traditional group, the CD3+ , CD4+ and CD8+ in 24 h after operation were lower than those in pre-operation (P<0.05); the CD3+、CD4+、CD8+ in 72 h after operation were obviously higher than those in pre-operation and 24 h after operation (P<0.05). Conclusion Compared with traditional open hysterectomy, laparoscopic hysterectomy has less influence on immune function.
KEYWORDS: laparoscope; hysterectomy; immune function

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