本文選題：腹腔鏡 + 開腹手術(shù)　； 參考：《中國內(nèi)鏡雜志》2017年04期

【摘要】：目的探討腹腔鏡和開腹手術(shù)對卵巢良性腫瘤患者免疫功能相關(guān)指標的影響。方法以該院2015年1月-2016年1月收治的86例卵巢良性腫瘤患者為研究對象,按照隨機數(shù)值表分組法將患者隨機分為對照組和觀察組,每組各43例。對照組進行傳統(tǒng)開腹手術(shù),觀察組則進行腹腔鏡手術(shù)。記錄兩組患者手術(shù)前及手術(shù)后免疫功能相關(guān)指標變化,分別測定手術(shù)前1天、術(shù)后第1天以及術(shù)后第3天的外周血白細胞數(shù)量(WBC)、中性粒細胞比率(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反應(yīng)蛋白(CRP)含量以及T淋巴細胞亞群(CD3~+、CD4~+和CD3~+/CD4~+比值)分布情況,記錄術(shù)后并發(fā)癥發(fā)生率,并進一步進行統(tǒng)計學分析。結(jié)果術(shù)前兩組患者IgA、IgG和IgM相比,差異無統(tǒng)計學意義(P0.05),術(shù)后兩組僅IgG含量較術(shù)前明顯下降,差異具有統(tǒng)計學意義(P0.05);對照組患者的WBC、NGR、CRP在術(shù)后第1和3天均較術(shù)前有明顯上升,而觀察組僅CRP較術(shù)前呈現(xiàn)增高狀態(tài);對照組與觀察組的組間比較均有明顯差異(P0.05);術(shù)前兩組之間CD3~+、CD4~+和CD3~+/CD4~+比值無差異,差異無統(tǒng)計學意義(P0.05)。但術(shù)后兩組均出現(xiàn)下降,且對照組下降更為明顯,組間差異有統(tǒng)計學意義(P0.05);術(shù)后觀察組并發(fā)癥發(fā)生率為6.98%,對照組為16.28%。結(jié)論臨床使用腹腔鏡技術(shù)治療卵巢良性腫瘤相對于傳統(tǒng)開腹手術(shù),能有效減少對患者免疫系統(tǒng)的影響,具有較高的安全性,有助于患者的恢復(fù),值得推廣應(yīng)用。
[Abstract]:Objective to investigate the effect of laparoscopy and laparotomy on immune function in patients with benign ovarian tumors. Methods from January 2015 to January 2016, 86 patients with benign ovarian tumors were randomly divided into control group (n = 43) and observation group (n = 43). Traditional laparotomy was performed in the control group and laparoscopic surgery was performed in the observation group. The changes of immune function were recorded before and after operation. The levels of WBCU, neutrophil ratio and immunoglobulin A (IgA) in peripheral blood were measured 1 day before operation, 1 day after operation and 3 days after operation, respectively. The level of immunoglobulin G (IGG), the level of immunoglobulin (IgM) and the content of C-reactive protein (CRP), and the distribution of CD3 ~ + CD4 ~ and CD3- / CD4~ ratio of T lymphocyte subsets were recorded, and the incidence of postoperative complications was recorded and analyzed statistically. Results there was no significant difference between the two groups in IgA IgG and IgM before operation (P 0.05), but the content of IgG in the two groups was significantly lower than that before operation, and the difference was statistically significant (P 0.05), and that in the control group was significantly higher on the 1st and 3rd day after operation than that before operation. However, the CRP of the observation group was higher than that of the control group, the difference between the control group and the observation group was significant (P 0.05), and there was no significant difference between the two groups before operation in the ratio of CD3 ~ + CD4 ~ and CD3- / CD4 ~, there was no significant difference between the two groups (P 0.05). However, there was a decrease in the two groups after operation, and the decrease in the control group was more obvious, the difference between the two groups was statistically significant (P 0.05), the incidence of postoperative complications was 6.98 in the observation group and 16.28 in the control group. Conclusion Laparoscopic therapy for benign ovarian tumors can effectively reduce the influence on the immune system of patients with benign ovarian neoplasms compared with the traditional open surgery. It is safe and helpful to the recovery of patients. It is worth popularizing and applying.
【作者單位】： 中南大學湘雅醫(yī)院婦產(chǎn)科;
【分類號】：R737.31

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