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目的比较腹腔镜下子宫肌瘤剔除术与开腹子宫肌瘤剔除术的临床疗效,并观察两种术式对患者机体免疫功能影响。方法选取2010年1月至2015年1月在我院妇产科行子宫肌瘤剔除术的患者200例,根据手术方案不同分为观察组与对照组各100例。观察组进行腹腔镜子宫肌瘤剔除术,对照组进行开腹子宫肌瘤剔除术。观察两组患者的一般手术情况,并对手术前后的血清免疫球蛋白IgM、IgG、IgA进行对比。结果观察组手术耗时[(76.42±15.72)min vs(99.67±19.15)min]、出血量[(203.44±48.26)ml vs(341.62±63.71)ml]、排气时间[(12.2±0.21)h vs(15.5±0.32)h]、下床时间[(16.47±5.65)d vs(26.79±7.73)d]以及住院时间[(4.1±1.3)d vs(7.3±2.9)d]等均明显低于对照组,差异均具有统计学意义(P<0.05);两组患者IgG水平在术后1 d即出现明显降低,观察组在术后3 d恢复至术前水平,而对照组未恢复至术前水平;术后12 h、48 h、72 h观察组疼痛情况均明显低于对照组,差异均具有统计学意义(P<0.05);观察组术后在子宫异常率、症状缓解率及子宫肌瘤复发率方面与对照组比较,差异均无统计学意义(P>0.05),但观察组术后并发症发生率为6.0%(6/100),低于对照组的20.0%(20/100),差异有统计学意义(P<0.05)。结论腹腔镜子宫肌瘤剔除术对患者的损伤较小,术后康复较快,且对细胞免疫以及体液免疫功能造成的影响较小,手术对机体的应激反应小,值得推广。
Objective To compare the clinical efficacy of laparoscopic myomectomy and laparoscopic myomectomy and observe the effects of the two surgical procedures on the immune function of patients. Methods From January 2010 to January 2015 in our hospital obstetrics and gynecology myomectomy in patients with 200 cases, divided into observation group and control group according to the different surgical options of 100 cases. The observation group underwent laparoscopic myomectomy and the control group underwent open myomectomy. The general operation of the two groups was observed, and the serum immunoglobulin IgM, IgG, IgA before and after surgery were compared. Results The operation time of the observation group was (76.42 ± 15.72) min vs (99.67 ± 19.15) min and the bleeding volume was (203.44 ± 48.26) ml vs (341.62 ± 63.71) ml and the exhaust time was (12.2 ± 0.21) h vs (15.5 ± 0.32) h], time to bed [(16.47 ± 5.65) d vs (26.79 ± 7.73) d], and hospital stay [(4.1 ± 1.3) d vs (7.3 ± 2.9) d] Control group, the difference was statistically significant (P <0.05); two groups of patients with IgG levels decreased significantly after 1 d, the observation group at 3 d after surgery to restore the preoperative level, while the control group did not recover to surgery (P <0.05). The rate of abnormal uterus, symptom relief and the uterus in the observation group after operation were significantly lower than those in the control group The recurrence rate of fibroids was not significantly different from that of the control group (P> 0.05), but the incidence of postoperative complications in the observation group was 6.0% (6/100), which was lower than that in the control group (20.0%, 20 / 100), the difference was statistically significant (P <0.05). Conclusions Laparoscopic myomectomy has less damage to patients and faster postoperative recovery, and has less impact on cellular immunity and humoral immune function. Surgery is less stressful to the body and is worth promoting.