微型腹腔镜、普通腹腔镜和剖腹手术对机体免疫功能影响比较

目的：比较微型腹腔镜、普通腹腔镜和剖腹手术对机体免疫功能的影响。方法：对90例需行妇科手术的患者分成微型腹腔镜组（微型组）30例、普通腹腔镜组（普通组）30例和剖腹手术组（剖腹组）30例，测定术前、术后24h及48h静脉血清白细胞介素-6（IL-6）、白细胞介素-8（IL-8）及超氧化物歧化酶SOD水平。结果：三组术后24h及48h血清IL-6、IL-8明显高于术前（P〈0.01），剖腹组显著高于微型组（P〈O．01），但普通组与微型组无显著性差异（P〉0．05）；三组术后24h及48h血清超氧化物歧化酶SOD均有下降（P〈0.01），剖腹较微型组下降更明显（P〈0.01），但普通组与微型组无显著性差异（P〉0.05）。结论；微型腹腔镜比剖腹手术引起机体免疫功能变化更小，但尚不能得出微型腹腔镜比普通腹腔镜引起机体免疫功能变化更小的结论。

Effects of Microlaparoscopy and Laparoscopy and Laparotomy on Immune Function of Patients

Objectives ：To compare the effects of microlaparoscopy, laparoscopy and laparotomy on immune function of patients. Methods：Ninty patients were divided into the microlaparoscopy, laparoscopy and laparotomy groups with 30 in each group. The serum interleukin-6（IL-6）,interleukin-8（IL-8）and superoxide dismutase（SOD） from venous blood before operation and 24 and 48 h after operation were measured. Results：The levels of IL-6 and IL-8 increased markedly at 24 h and 48 h postoperatively in all groups （P〈0. 01）,Both IL-6 and IL-8 in laparotomy group significantly higher than that of microlaparoscopy group （P〈0. 01）,whereas there were no significant difference between microlaparoseopy and laparoscopy groups（P〈0.05）. The SOD levels decreased markedly at 24h and 48h postoperatively in all groups （P〈0.01）, and much lower in laparotomy than microlaparoscopy group （P〈0.01）,but there were no significant difference between microlaparoscopy and laparoscopy groups （P〈0. 05）. Conclusion：The microlaparoscopy causes less effects on immune function than laparotomy did dew to less tissue injury,whereas have no obvious evidences that the microlaparoscopy causes less effects than laparoscopy.