摘要
目的探讨腹腔镜宫颈癌根治术(laparoscopic radical hysterectomy,LRH)以及开腹宫颈癌根治术(abdominal radical hysterectomy,ARH)对早期宫颈癌患者机体的局部以及免疫系统的影响。方法选取早期(Ⅰa2~Ⅱa1)宫颈癌患者210例,分LRH组(行腔镜手术)118例,ARH组(行腹式手术)92例。分别在术前1天、术后1天、术后3天抽取观察组和对照组患者肘部静脉血10 ml,在术中(在开腹后或者腹腔镜进入腹部后立刻抽取腹腔冲洗液)、术后1天、术后3天抽取患者腹腔液5 ml,利用流式细胞术检测腹腔液中和外周血TH1/TH2细胞因子,比较LRH组和ARH组术前术后免疫状态的变化。结果术后第1天ARH组TNF-α水平上升,然而LRH组变化不明显;术后第3天ARH组表达水平继续上升,LRH组变化不大,两组间差异具有统计学意义(P<0.05)。术后1天2组的TH1/TH2比值均下降,与术前1天相比相对降低,组间差异具有统计学意义(P<0.05);术后1月,2组患者TH1/TH2比值恢复术前水平。ARH组术后1天至术后3天IL-6水平比术中升高(P<0.05),而LRH组升高程度较小(P<0.05)。结论腔镜下宫颈癌根治术与开腹宫颈癌根治术相比对于全身的免疫系统干扰更小,并且创伤更小,恢复更迅速,可以广泛应用于宫颈癌的临床治疗。
Objective To study the effect of laparoscopic radical hysterectomy（ LRH） and abdominal radical hysterectomy（ ARH） on patients＇ immune system. Methods 210 cases of（ Ⅰa2 - Ⅱa1） patients with early cervical cancer were divided into the observation group and the control group,the experimental group received LRH（ 118 cases） and the control group received ARH（ 92 cases）. Respectively 1 day before surgery,1 day,3 days after extraction of the 2 groups elbow venous blood 10 ml,during surgery（ laparotomy or laparoscopy after extraction into the abdomen immediately peritoneal fluid）,after 1 day,3 days after extracting 5ml peritoneal fluid of patients using flow cytometry before change in peritoneal fluid and peripheral blood of TH1/TH2 cytokines,the experimental group and control group postoperative immune status. Results After first days,the level of TNF-α in ARH group increased,but the change of LRH group was not obvious. The expression level of ARH Group continued to rise third days after operation,and the change of LRH group was not big. The difference between two groups was statistically significant（ P〈0. 05）. 1 days after operation,the ratio of TH1/TH2 in the 2 groups decreased,compared with the 1 day before operation,the difference was statistically significant（ P〈0. 05）,and in January,the ratio of TH1/TH2 in the two groups was restored to the preoperative level. In the ARH group,the IL-6 level increased 1 days after operation and 3 days after operation（ P〈0. 05）,while the LRH group was less elevated（ P〈0. 05）. Conclusion Compared with open radical cervical surgery,laparoscopic radical surgery for cervical cancer has less interference to the systemic immune system,less trauma and quicker recovery.It can be widely used in the clinical treatment of cervical cancer.
出处
《实用癌症杂志》
2017年第9期1527-1530,共4页
The Practical Journal of Cancer
