摘要
目的:比较腹腔镜手术和开腹手术对早期宫颈癌子宫全切术术后疲劳综合征(POFS)和免疫功能的影响。方法:选取2014年1月—2015年12月第三军医大学大坪医院妇产科收治的78例早期宫颈癌患者,按手术方式分为腹腔镜组(43例)和开腹组(35例),比较2组的手术情况,采用Christensen评分法评价术前1 d、术后1 d、3 d和7 d的疲劳程度,并检测各个时间点患者的血清免疫球蛋白IgA、IgG、IgM水平、血浆自然杀伤(NK)细胞计数、T细胞亚群CD4^+、CD8^+、CD4^+/CD8^+水平。结果:腹腔镜组手术时间长于开腹组,但术中出血量和术后住院时间少于开腹组,差异均有统计学意义(P<0.05)。2组患者术后的POFS评分均显著高于术前1 d,且随着术后时间延长,POFS评分均逐渐降低;腹腔镜组各个时间点的POFS评分和恢复效果均显著好于开腹组,差异均有统计学意义(P<0.05)。术后2组患者的免疫球蛋白水平和T细胞亚群计数均较术前1 d显著下降,但腹腔镜组下降程度低于开腹组,恢复效果好于开腹组,差异有统计学意义(P<0.05)。结论:腹腔镜子宫全切术治疗早期宫颈癌对患者创伤小,对免疫功能抑制轻微,POFS程度轻,手术效果好,临床恢复快,值得临床推广应用。
Objective：To observe the influence of laparoscopic surgery and laparotomy on postoperative fatigue syndrome（POFS） and immunity function in early cervical cancer patients with hysterectomy.Methods：78 patients with early cervical cancer who were admitted from January 2014 to December 2015 in our hospital were divided into laparoscopic surgery group,43 cases,and laparotomy group 35 cases.The general information of operation,fatigue score by Christensen evaluation method and immunity function before operation and postoperative 1 d,3 d and 7 d were compared between the two groups.Results：The laparoscopic surgery time is longer than laparotomy,but intraoperative blood loss and postoperative hospital stay was significantly less than laparotomy group（P〈0.05）.After operation,all the patients′ POFS score was higher than preoperative,and declined gradually over time,while the laparoscopic group improved more significantly than the laparotomy group（P〈0.05）.The immune globulin level and T cell subgroup count declined significantly after operation,and the laparoscopic group declined less than the laparotomy group（P〈0.05）,the recovery effect in laparoscopic group was better than laparotomy group（P〈0.05）.Conclusions：The laparoscopic hysterectomy for early cervical cancer caused less trauma on patients and less immunity function inhibition,could reduced the POFS degree and improve the operation effect and promote clinical rehabilitation.It′s worthy of clinical popularization.
出处
《国际妇产科学杂志》
CAS
2017年第5期512-515,共4页
Journal of International Obstetrics and Gynecology
关键词
宫颈肿瘤
腹腔镜
腹腔镜检查
术后疲劳综合征
疲劳综合征
慢性
手术后并发症
免疫
Uterine cervical neoplasms
Laparoscopes
Laparoscopy
Postoperative fatigue syndrome
Fatigue syndrome,chronic
Postoperative complications
Immunity
