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目的探讨腹腔镜与开腹手术治疗卵巢良性畸胎瘤的疗效以及对患者免疫功能的影响。方法选取2015年2月-2017年3月来吉林医药学院附属医院就诊的卵巢良性肿瘤行开腹手术患者与腹腔镜手术患者各40例,检测术前24 h、术后24 h、术后72 h外周血白细胞介素-18(IL-18)及T淋巴细胞亚群CD_4~+/CD_8~+水平,将两种方式的手术时间、患者出血量、术后排气时间进行对比。结果 (1)术后24、72 h两组IL-18水平均高于术前(P<0.05),且术后24 h上升明显(P<0.01),术后72 h下降,下降程度显著低于腹腔镜组(P<0.05),腹腔镜组患者在手术后72 h的恢复程度接近术前水平;(2)术后24、72 h两组T淋巴细胞亚群CD_4~+/CD_8~+均有所下降,且术后24 h下降明显(P<0.05),术后72 h有所上升,程度显著低于腹腔镜组(P<0.05),腹腔镜组患者在手术后72 h的恢复程度接近术前水平;(3)两组相比,腹腔镜组患者的手术时间短、手术出血量少、术后排气早(P<0.01)。结论对于卵巢良性畸胎瘤患者采用腹腔镜手术治疗的效果好,对细胞和体液免疫产生的影响均较小,对机体损伤小,术后修复快。
Objective To investigate the effect of laparoscopy and laparotomy on benign ovarian teratoma and its influence on immune function. Methods From February 2015 to March 2017, 40 patients with open benign ovarian tumors who underwent open surgery at the Affiliated Hospital of Jilin Medical College and patients undergoing laparoscopic surgery were enrolled. Twenty-four hours before operation, 24 hours after operation and 72 h, peripheral blood interleukin-18 (IL-18) and T lymphocyte subsets CD_4 ~ + / CD_8 ~ + levels, the two methods of operation time, patient bleeding, postoperative exhaust time were compared. Results (1) The levels of IL-18 in both groups were significantly higher than those before operation (P <0.05) 24 h and 72 h after operation, and increased significantly 24 h after operation (P <0.01) In the laparoscopic group (P <0.05), the recovery of laparoscopic group at 72 h after operation was close to the preoperative level. (2) The T lymphocyte subsets CD_4 ~ + / CD_8 + (P <0.05), and increased at 72 h after operation, which was significantly lower than that of laparoscopic group (P <0.05). The laparoscopic group recovered at 72 h after operation (3) Compared with the two groups, laparoscopic group had shorter operation time, less operation bleeding and early postoperative exhaust (P <0.01). Conclusion The treatment of benign ovarian teratoma with laparoscopic surgery has good effect on the cellular and humoral immune effects are small, the body injury is small, fast repair.