腹腔镜手术对早期子宫内膜癌患者术后CD4/CD8水平及IgG表达的影响(1)
[摘要]目的 探讨腹腔镜手术对早期子宫内膜癌患者术后CD4/CD8水平及IgG表达的影响。方法 选择2014年9月～2016年9月我院收治的88例早期子宫内膜癌患者，采用随机数字表法分为观察组与对照组，各44例。对照组采用开腹手术，观察组采用腹腔镜手术治疗。比较两组的围术期指标、免疫功能指标[辅助性T细胞/细胞毒性T细胞(CD4+/CD8+)、免疫球蛋白G(IgG)]及并发症发生率。结果 观察组的术中出血量、盆腔引流量等均显著少于对照组，术后排气时间短于对照组，差异有统计学意义(P<0.05)。观察组手术后的CD4+/CD8+水平高于对照组，IgG水平低于对照组，差异有统计学意义(P<0.05)。结论 腹腔镜手术是一种安全可靠的早期子宫内膜癌治疗方式，可有效减轻对患者免疫功能的影响，促进术后生理功能恢复，值得推广。
[关键词]早期子宫内膜癌；腹腔镜手术；免疫功能；开腹手术
[中图分类号] R737.33 [文献标识码] A [文章编号] 1674-4721(2017)05(a)-0094-03
[Abstract]Objective To investigate the influence of laparoscopic surgery on postoperative CD4/CD8 level and IgG expression in patients with early endometrial carcinoma.Methods 88 patients with early endometrial carcinoma in our hospital from September 2014 to September 2016 were selected and divided into the observation group and the control group by random number table method，44 cases in each group.The control group was treated with open surgery and the observation group was treated with laparoscopic surgery.The perioperative indexes，indexes of immune function [T helper cell/cytotoxic T cell (CD4+/CD8+)，immunoglobulin G (IgG)] and the incidence rate of complications of the two groups were compared.Results The amount of intraoperative bleeding and pelvic drainage volume in the observation group was significantly less than that in the control group，and the postoperative exhaust time in the observation group was shorter than that of the control group，with significant difference (P<0.05).The level of CD4+/CD8+ after operation of the observation group was significantly higher than that of the control group，and IgG expression after operation of the observation group was significantly lower than that of the control group，with significant difference (P<0.05).Conclusion Laparoscopic surgery is a safe and reliable treatment method of early endometrial carcinoma，it can effectively reduce the influence on immune function，promote postoperative recovery of physiological function，which is worthy of promotion.
[Key words]Early endometrial carcinoma；Laparoscopic surgery；Immune function；Open surgery
子宮内膜癌多发于围绝经期与绝经后女性，主要症状为不规则阴道出血、阴道排液、下腹痛、腹部包块等[1]。临床研究显示，子宫内膜癌发病率持续升高，在女性生殖道恶性肿瘤中占20%～30%，严重威胁女性的生命安全[2]。目前，多数子宫内膜癌患者可于早期发现病情，采用切除术治疗可有效增加5年生存率。传统手术方式多为开腹全子宫切除、双侧附件切除等，具有一定的临床疗效，但术后极易引发并发症[3]。另外，部分患者因年龄、机体等差异而对手术耐受力不同，导致手术应用受限。随着医学技术的进步与医疗器械的发展，腹腔镜技术逐渐应用于早期子宫内膜癌治疗中，并因创伤轻、出血少、并发症少、恢复快等优势而备受青睐[4]。本研究通过对比开腹手术疗效，探讨腹腔镜手术对患者术后免疫功能的影响，现报道如下。
1资料与方法
1.1一般资料
选择2014年9月～2016年9月我院收治的88例早期子宫内膜癌患者，采用随机数字表法分为观察组与对照组，各44例。观察组中，年龄45～76岁，平均(57.48±5.36)岁；病理类型：子宫内膜样腺癌28例，黏液腺癌5例，浆液腺癌7例，透明细胞癌4例。对照组中，年龄46～77岁，平均(58.05±5.44)岁；病理类型：子宫内膜样腺癌27例，黏液腺癌6例，浆液腺癌8例，透明细胞癌3例。两组的年龄、病理类型等一般资料比较，差异无统计学意义(P>0.05)，具有可比性。 (汪紫燕)
[关键词]早期子宫内膜癌；腹腔镜手术；免疫功能；开腹手术
[中图分类号] R737.33 [文献标识码] A [文章编号] 1674-4721(2017)05(a)-0094-03
[Abstract]Objective To investigate the influence of laparoscopic surgery on postoperative CD4/CD8 level and IgG expression in patients with early endometrial carcinoma.Methods 88 patients with early endometrial carcinoma in our hospital from September 2014 to September 2016 were selected and divided into the observation group and the control group by random number table method，44 cases in each group.The control group was treated with open surgery and the observation group was treated with laparoscopic surgery.The perioperative indexes，indexes of immune function [T helper cell/cytotoxic T cell (CD4+/CD8+)，immunoglobulin G (IgG)] and the incidence rate of complications of the two groups were compared.Results The amount of intraoperative bleeding and pelvic drainage volume in the observation group was significantly less than that in the control group，and the postoperative exhaust time in the observation group was shorter than that of the control group，with significant difference (P<0.05).The level of CD4+/CD8+ after operation of the observation group was significantly higher than that of the control group，and IgG expression after operation of the observation group was significantly lower than that of the control group，with significant difference (P<0.05).Conclusion Laparoscopic surgery is a safe and reliable treatment method of early endometrial carcinoma，it can effectively reduce the influence on immune function，promote postoperative recovery of physiological function，which is worthy of promotion.
[Key words]Early endometrial carcinoma；Laparoscopic surgery；Immune function；Open surgery
子宮内膜癌多发于围绝经期与绝经后女性，主要症状为不规则阴道出血、阴道排液、下腹痛、腹部包块等[1]。临床研究显示，子宫内膜癌发病率持续升高，在女性生殖道恶性肿瘤中占20%～30%，严重威胁女性的生命安全[2]。目前，多数子宫内膜癌患者可于早期发现病情，采用切除术治疗可有效增加5年生存率。传统手术方式多为开腹全子宫切除、双侧附件切除等，具有一定的临床疗效，但术后极易引发并发症[3]。另外，部分患者因年龄、机体等差异而对手术耐受力不同，导致手术应用受限。随着医学技术的进步与医疗器械的发展，腹腔镜技术逐渐应用于早期子宫内膜癌治疗中，并因创伤轻、出血少、并发症少、恢复快等优势而备受青睐[4]。本研究通过对比开腹手术疗效，探讨腹腔镜手术对患者术后免疫功能的影响，现报道如下。
1资料与方法
1.1一般资料
选择2014年9月～2016年9月我院收治的88例早期子宫内膜癌患者，采用随机数字表法分为观察组与对照组，各44例。观察组中，年龄45～76岁，平均(57.48±5.36)岁；病理类型：子宫内膜样腺癌28例，黏液腺癌5例，浆液腺癌7例，透明细胞癌4例。对照组中，年龄46～77岁，平均(58.05±5.44)岁；病理类型：子宫内膜样腺癌27例，黏液腺癌6例，浆液腺癌8例，透明细胞癌3例。两组的年龄、病理类型等一般资料比较，差异无统计学意义(P>0.05)，具有可比性。 (汪紫燕)