子宫切除术式对机体免疫功能影响.docVIP

子宫切除术式对机体免疫功能影响 　　[摘要] 目的：研究经腹全子宫切除及经阴道全子宫切除对患者免疫功能的影响。方法：随机选择在我院接受手术治疗的子宫肌瘤及子宫腺肌病患者40例，其中20例施行经腹全子宫切除，20例施行经阴道全子宫切除，监测患者术前、术后第1天、术后第3天的外周血淋巴细胞(PBL)亚群、血清免疫球蛋白IgG、IgM、IgA、C反应蛋白(CRP)、白细胞介素-6(IL-6)和肿瘤坏死因子(TNF)的变化。结果：两组患者围手术期各时点PBL亚群、血清IgA与IgM水平均无明显改变(P0.05)，组间各对应时点比较亦无显著性差异(P0.05)。两组术后24 h血清IgG均有下降(P0.05)，但腹式组较阴式组下降更明显(P0.05)，且持续超过72 h。血清CRP和IL-6水平术后24 h均较术前明显升高(P0.05)，腹式组增高明显高于阴式组(P0.05)，且腹式组72 h后仍未恢复到术前水平。结论：阴式子宫切除术对机体体液免疫功能的影响比腹式子宫切除术小。 　　[关键词] 腹式子宫切除；阴式子宫切除；免疫功能 　　[中图分类号]R713.4[文献标识码]A [文章编号]1673-7210（2007）08（b）-007-03 　　 　　The influence of abdominal hysterectomy and vaginal hysterectomy on 　　the patients immune function 　　WU Li-ling 　　（Department of Obstetrics and Gynecology, Pengpai Memorial Hospital of Haifeng County, Haifeng 516400, China） 　　[Abstract] Objective: To study the influence of total hysterectomy via abdomen or via vagina on immune function of patients． Methods：Forty patients with hysteromyoma or adenomyosis were chosen and divided into two groups randomly. Patients in abdominohysterectomy group received hysterectomy via abdomen, while those in vaginal hysterectomy group received hysterectomy via vagina. Immune parameters including T cell subsets, serum immunoglobulin (IgG，IgA，IgM) , interleukin-6(IL-6), C reacting protein(CRP), and TNF-α levels were assessed preoperatively and on postoperative days 1 and 3. Results: The T cell subsets, the level of serum IgA and IgM did not change after operation in both groups(P0.05). But the level of serum IgG was significantly decreased after operation in two groups, especially in abdominohysterectomy group(P0.05)．The level of serum CRP and IL-6 in both groups were significantly increased after operation, especially in abdominohysterectomy group (P0.05) and went on for more than three days (P0.05). Conclusion: The influence on the humoral immune function in patients received vaginal hysterectomy was less than that in patients received abdominohysterectomy． 　　[Key words] Vaginal hysterectomy; Abdominal