摘要
目的探讨腹腔镜微创手术治疗卵巢良性肿瘤卵巢功能与免疫功能的保护作用。方法选择2012年1月至2015年9月北京市海淀医院接诊的108例卵巢良性肿瘤的患者为研究对象。采用随机数字法将患者分为腹腔镜组(52例)和开腹手术组(56例)。腹腔镜组患者行腹腔镜微创手术治疗;开腹手术组行传统开腹手术治疗。比较两组患者的术后排气时间、住院时间、下床活动时间、手术出血量、并发症发生情况以及卵巢功能[雌二醇、黄体生成素(LH)、促卵泡激素(FSH)]和免疫功能[免疫球蛋白(Ig)G、Ig A、Ig E]的恢复情况。结果腹腔镜组患者术中出血量、术后排气时间、住院时间、下床活动时间、住院费用均显著少于开腹手术组[(10.8±2.8)m L比(48.3±5.5)m L、(1.0±0.3)d比(1.9±0.4)d、(5.2±0.7)d比(8.0±0.9)d、(1.2±0.3)d比(1.9±0.9)d、(4 220±221)元比(6 078±200)元](P<0.05);腹腔镜组术后镇痛率和并发症发生率低于开腹手术组(P<0.05);治疗后两组患者雌二醇水平较治疗前降低,LH、FSH水平较治疗前升高(P<0.05);治疗后腹腔镜组雌二醇水平低于开腹手术组[(60.0±3.6)mmol/L比(66.6±4.8)mmol/L],LH、FSH水平高于开腹手术组[(17.0±1.1)U/L比(11.4±1.1)U/L、(20.0±1.6)U/L比(12.7±1.5)U/L](P<0.05);治疗后腹腔镜组Ig G、Ig A高于开腹手术组(13.1±1.8)g/L比(10.8±1.7)g/L、(1.9±0.1)g/L比(1.4±0.3)g/L,Ig E低于开腹手术组[(121±28)g/L比(145±27)g/L,P<0.05]。结论腹腔镜微创手术治疗卵巢良性肿瘤效果良好,可缩短手术时间、减少术中出血量,保护卵巢功能与免疫功能,值得在临床中推广应用。
Objective To study the treatment effectiveness of minimally invasive laparoscopic surgery on benign ovari- an tumor and its effect on ovarian function and immune function. Methods From Jan. 2012 to Sep. 2015,108 patients with benign ovarian tumor in Beijing Haidian Hospital were included in the study. According to the random number method ,they were divided into a laparoscopic group（52 cases） and an open surgery group（56 cases）. The laparoscopic group was treated by minimally invasive laparoscopic surgery; the open surgery group was given open surgery. The postoperative discharge time,length of stay, ambulation time, blood loss, complications and ovarian function [ estradio, luteinizing hormone （ LH ）, follicle-stimulating hormone （FSH） ] and immune function [ immnnoglobulin （ Ig ） G, IgA, IgE ] of the two groups were compared. Results The intraoperative bleeding, postoperative exhaust time, hospitalization time, ambulation time and hospitalization costs of the patients in laparoscopic group were significantly less than those in laparotomy group [ （ 10.8 ± 2. 8） mL vs （48.3 ±5.5） mL, （1.0 ±0.3） d vs （1.9 ±0.4） d,（5.2 ±0.7） d vs （8.0 ±0.9） d, （1.2 ±0.3） d vs （ 1.9 ± 0.9 ） d, （4 220 ± 221 ） yuan vs （6 078 ± 200） yuan ] （ P 〈 0. 05 ） ; Postoperative analgesia rate and incidence of complications of the laparoscopic group were lower than those in the open surgery group （ P 〈 0.05 ） ; Estradiol levels in the two groups were decreased after treatment than before treatment, LH and FSH levels were higher than before treatment （ P 〈 0. 05 ） ; The level of estradiol in the laparoscopic group was lower than that in the open surgery group after treatment [ （ 60.0 ± 3.6 ） mmol/L vs （ 66.6 ± 4.8 ） mmol/L ], LH and FSH levels were significantly higher than those in open surgery group [（17.0±1.1） U/Lvs （11.4±1.1） U/L,（20.0±1.6） U/Lvs （12.7±1.5） U/L]（P〈O. OS）;The level of IgG, IgA of laparoscopic group were higher than those in open surgery group after treatment [ （ 13.1 ± 1.8） g/L vs （10.8 ± 1.7）g/L, （1.9 ±0. 1） g/L vs （1.4 -±0.3） g/L], IgE was lower than that in the laparotomy group [ （121 ±28） g/L vs （145 ±27） g/L] （P 〈0. 05）. Conclusion The effectiveness of minimally invasive laparoscopic surgery for treatment of benign ovarian tumor is good,which can shorten the operation time, reduce the blood loss,protect ovarian function and immune function, thus is worthy of promotion in clinical.
作者
韩娟
张萌萌
HAN Juan ZHANG Mengmeng.(Department of Gynecology and Obstetrics, Beijing Haidian Hospital ,Beijing 100080 ,China)
出处
《医学综述》
2017年第1期201-204,共4页
Medical Recapitulate
关键词
卵巢良性肿瘤
腹腔镜微创手术
卵巢功能
免疫功能
Benign ovarian tumors
Minimally invasive laparoscopic surgery
Ovarian function
Immune function
