国际妇产科学杂志

国际妇产科学杂志 ›› 2017, Vol. 44 ›› Issue (5): 512-515.

• 论著 • 上一篇    下一篇

不同手术方式对宫颈癌根治术后疲劳综合征和免疫功能的影响

余欣梅   

  1. 400042  重庆，第三军医大学大坪医院妇产科
  • 收稿日期:2017-05-22 修回日期:2017-08-28 出版日期:2017-10-15 发布日期:2017-10-25

Influence of Different Surgical Procedure on Postoperative Fatigue Syndrome and Immunity Function in Cervical Cancer Patients

YU Xin-mei   

  1. Department of Obstetrics and Gynecology，Daping Hospital of The Third Military Medical University，Chongqing 400042，China
  • Received:2017-05-22 Revised:2017-08-28 Published:2017-10-15 Online:2017-10-25

PDF (PC)

6401

摘要： 目的：比较腹腔镜手术和开腹手术对早期宫颈癌子宫全切术术后疲劳综合征（POFS）和免疫功能的影响。方法：选取2014年1月—2015年12月第三军医大学大坪医院妇产科收治的78例早期宫颈癌患者，按手术方式分为腹腔镜组（43例）和开腹组（35例），比较2组的手术情况，采用Christensen评分法评价术前1 d、术后1 d、3 d 和7 d的疲劳程度，并检测各个时间点患者的血清免疫球蛋白IgA、IgG、IgM水平、血浆自然杀伤（NK）细胞计数、T细胞亚群CD4+、CD8+、CD4+/CD8+水平。结果：腹腔镜组手术时间长于开腹组，但术中出血量和术后住院时间少于开腹组，差异均有统计学意义（P＜0.05）。2组患者术后的POFS评分均显著高于术前1 d，且随着术后时间延长，POFS评分均逐渐降低；腹腔镜组各个时间点的POFS评分和恢复效果均显著好于开腹组，差异均有统计学意义（P＜0.05）。术后2组患者的免疫球蛋白水平和T细胞亚群计数均较术前1 d显著下降，但腹腔镜组下降程度低于开腹组，恢复效果好于开腹组，差异有统计学意义（P＜0.05）。结论：腹腔镜子宫全切术治疗早期宫颈癌对患者创伤小，对免疫功能抑制轻微，POFS程度轻，手术效果好，临床恢复快，值得临床推广应用。

关键词: 宫颈肿瘤, 腹腔镜, 腹腔镜检查, 术后疲劳综合征, 疲劳综合征, 慢性, 手术后并发症, 免疫

Abstract: Objective：To observe the influence of laparoscopic surgery and laparotomy on postoperative fatigue syndrome (POFS) and immunity function in early cervical cancer patients with hysterectomy. Methods：78 patients with early cervical cancer who were admitted from January 2014 to December 2015 in our hospital were divided into laparoscopic surgery group, 43 cases, and laparotomy group 35 cases. The general information of operation, fatigue score by Christensen evaluation method and immunity function before operation and postoperative 1 d, 3 d and 7 d were compared between the two groups. Results：The laparoscopic surgery time is longer than laparotomy, but intraoperative blood loss and postoperative hospital stay was significantly less than laparotomy group (P＜0.05). After operation, all the patients′ POFS score was higher than preoperative, and declined gradually over time, while the laparoscopic group improved more significantly than the laparotomy group (P＜0.05). The immune globulin level and T cell subgroup count declined significantly after operation, and the laparoscopic group declined less than the laparotomy group (P＜0.05), the recovery effect in laparoscopic group was better than laparotomy group (P＜0.05). Conclusions：The laparoscopic hysterectomy for early cervical cancer caused less trauma on patients and less immunity function inhibition, could reduced the POFS degree and improve the operation effect and promote clinical rehabilitation. It′s worthy of clinical popularization.

Key words: Uterine cervical neoplasms, Laparoscopes, Laparoscopy, Postoperative fatigue syndrome, Fatigue syndrome, chronic, Postoperative complications, Immunity