腹腔镜手术治疗大肌瘤对T细胞免疫功能的影响

The Effect of Laparoscopic Surgery for Larges on T Cell Immune Function

摘要: 目的：比较腹腔镜下及经腹子宫肌瘤剔除大肌瘤对患者T细胞免疫功能的影响。方法：腹腔镜组25例，开腹组21例，比较两组术后外周血T淋巴细胞亚群的表达。结果：开腹组术后24小时、72小时CD4+、CD8+及CD4+/CD8+比例较术前下降(P < 0.05)。腹腔镜组术后24小时、72小时CD4+、CD8+及CD4+/CD8+高于开腹组(P < 0.05)。两组患者术后24小时外周血Treg细胞较术前显著增加(P < 0.05)。开腹组术后72小时，有所下降，但仍高于术前(P < 0.05)。腹腔镜组术后24小时及72小时外周血Treg细胞比例较开腹组均显著下降(P < 0.05)。结论：腹腔镜下大肌瘤剔除对于细胞免疫功能的抑制程度明显低于开腹手术。

Abstract: Objective: To evaluate the effect of different surgery on the immune function of women with large uterine myoma by comparing laparoscopic and laparotomy myomectomy. Methods: The records of 25 women who underwent laparoscopic myomectomy and 21 women who underwent laparotomy myomectomy were reviewed. Peripheral blood was collected and T cell content was assayed. Results: CD4+, CD8+ and CD4+/CD8+ ratio in laparotomy group significantly decreased after 24 hours of operation (P < 0.05), proportion increased after 72 hours, but was still significantly lower than the preoperative values (P < 0.05). CD4+, CD8+ and CD4+/CD8+ in the laparoscopic group after 24 hours, 72 hours of operation were higher than in the laparotomy group (P < 0.05). The values of peripheral blood Treg cells proportion after 24 hours in two groups postoperative increased significantly than the preoperative values (P < 0.05). The values in laparotomy group after 72 hours of operation declined, but were still higher than in pre-operation (P < 0.05). The values in laparoscopic group have been markedly reduced after 72 hours; there was no statistically significant difference when compared with preoperative values (P < 0.05). Peripheral blood Treg cells ratio in the laparoscopic group after 24 hours and 72 hours postoperative was significantly lower than in the laparotomy group (P < 0.05). Conclusion: The laparoscopic myomectomy is a feasible and safe approach in the surgical treatment of large uterine myomas. The inhibition effect of laparoscopy on cellular immune function was significantly lower than open operation, which can be more conducive to protect the body's immune function.