阴式与开腹子宫手术对免疫功能影响的研究

目的:研究阴式与开腹子宫手术术前后患者体液免疫、细胞免疫功能的变化,探讨阴式手术对机体免疫功能的影响。方法:选择阴式及开腹子宫手术患者各80例。测定两组术前、术后24小时和术后72小时补体C3、C4,急性期蛋白(CRP),T细胞亚群CD3+、CD4+、CD8+。结果:两组手术前后C4差异均无统计学意义(P>0.05);阴式组C3术后24小时较术前下降明显(P<0.05),术后72小时恢复至术前水平(P>0.05)。开腹组C3术后24小时较术前下降更明显(P<0.01),术后72小时尚未恢复至术前水平(P<0.05)。两组术后24小时、72小时CRP水平较术前显著升高(P均<0.01),组间比较:术后24小时、72小时CRP水平开腹组高于阴式组(P<0.01,P<0.05)。两组术后24小时CD3+、CD4+、CD8+均较术前下降,差异有统计学意义(P<0.05),术后72小时阴式组上述指标上升至接近术前水平(P>0.05),而开腹组CD3+、CD4+仍低于术前水平(P<0.05)。结论:阴式子宫手术比开腹手术对机体免疫功能影响小,有利于患者的恢复。

Effects of Trans-vaginal Versus Trans-abdominal Uterine Operation on Immune Function

Objective:To compare the effect of trans-vaginal uterine operation on immune functions withtrans-abdominal uterine operation.Methods:80 patients underwent trans-vaginal uterine operation,and 80 patients underwent trans-abdominal operation were enrolled.The levels of C3,C4,C-Reaction Protein(CRP),CD3 +,CD4 +,CD8+ were measured before the operation,the 24 hours and 72 hours after operation respectively for each patient.Results:The levels of C4 were similar before and after surgery in both groups(P>0.05).The levels of C3 decreased significantly at the 24 hours postoperatively in tran-vaginal groups(P<0.05),and return to the levels of pre-operation at the postoperative 72-hour(P>0.05).The levels of C3 in the trans-abdominal group decreased more significantly at the postoperative 24-hour(P<0.01),and still remained a lower level than pre-operation even at the postoperative 72-hour(P<0.05).CRP level increased significantly at the 24 hours and 72 hours postoperatively in both groups(P<0.01,P<0.01).As compared to trans-vaginal group,CRP level was higher in the trans-abdominal group at the 24 hours and 72 hourspostoperatively(P<0.01,P<0.05).CD3+、CD4+、CD8+ decreased significantly at the 24 hours after the operation in both groups(P<0.05).The levels in trans-vaginal group at the postoperative 72-hourreturned backto the levels at pre-operation(P>0.05).However,the levels of CD3+ and CD4+ in trans-abdominal group at the postoperative 72-hour still stayed at a lower level than pre-operation(P<0.05).Conclusions:Compared with trans-abdominal operation,trans-vaginal uterine operation had less impact on immune function,and benefited the patient with faster recovery.