腹腔镜子宫肌瘤剔除术对机体免疫功能影响的研究

目的：探讨腹腔镜子宫肌瘤剔除术对机体免疫功能的影响.方法： 采用腹腔镜术行子宫肌瘤剔除共28例（LO组）,选择同期行传统剖腹手术22例（CO组）.分别在术前及术后1、3和7 d测定患者外周血白细胞计数、中性粒细胞率（GRA%）;采用散射比浊法测定免疫球蛋白IgG、IgM、IgA及补体C3、C4水平;采用流式细胞仪测定CD3＋（T细胞总数）、CD4^＋（T辅助/诱导细胞）、CD8^＋（T抑制/杀伤细胞）的数量.结果：手术前2组患者各项指标差异无统计学意义（P＞0.05）;LO组术后1 d IgG、C3水平较术前有所下降（P＜0.05）,术后3 d基本恢复至术前水平（P＞0.05）,其余指标与术前比较无明显变化（P＞0.05）;CO组术后白细胞计数和GRA%明显增高（P＜0.01）,IgG、C3水平较术前明显下降（P＜0.01）;术后1 d CD3^＋、CD4^＋、CD8^＋均明显降低（P＜0.01）,术后3 d有所回升,7 d后基本恢复至术前水平.结论：腹腔镜子宫肌瘤剔除术对机体免疫功能的影响较传统剖腹术小,有利于病人的恢复.

Effect of laparoscopic operation on immune function in patients with uterine myomas

Objective: To study the effect of laparoscopic operation on immune function in patients with uterine myomas. Methods: In the study, a total of 28 patients with uterine myomas received laparoscopic operation, 22 patients were through conventional open operation. The white blood cell(WBC), granulocyte rate(GRA), IgG, IgM, IgA, complement 3(C3), complement 4(C4), and T lymphocyte subpopulation were measured at 1 d before and 1 and 3 and 7 d after operation respectively. Results WBC and GRA% increased significantly in CO group (P<0.01), but not in LO group (P>0.05) after operation. The IgG, and C3 levels decreased at 1 d postoperatively in both groups, but much lower in CO patients (P<0.01). At 1 d and 3 d after operation, the levels of CD3+, CD4+ and CD8+ in CO group decreased significantly (P<0.01), whereas those of LO group changed without statistical significance. Conclusions: Laparoscopic operation does not significantly affect immune function compared with conventional open operation because of less tissue injury, which will be advantageous for a rapid recovery.