宋自灵　李水莲

[關键词] 腹腔镜;良性卵巢肿瘤;T淋巴细胞;肿瘤坏死因子-α;白细胞介素-6

[中图分类号] R737.3          [文献标识码] B          [文章编号] 1673-9701（2021）17-0069-04

Effect of laparoscopic surgery on levels of T lymphocyte subsets （CD3+/CD4+/CD8+）， TNF-α and IL-6 in peripheral blood of patients with benign ovarian tumors

SONG  Ziling   LI  Shuilian

Department of Gynecology， the People′s Hospital of Wuzhou in Guangxi Zhuang Autonomous Region， Wuzhou   543002， China

[Abstract] Objective To explore the efficacy of laparoscopic surgery and its influence on the levels of T lymphocyte subsets， serum tumor necrosis factor-α （TNF-α）， and interleukin-6 （IL-6） in peripheral blood of patients with benign ovarian tumors. Methods A total of 120 patients with benign ovarian tumors scheduled for the surgery in our hospital from January 2015 to December 2018 were selected as the research objects. According to the random numbers generated by EXCEL2007， they were divided into the laparoscopic group and the laparotomy group， with 60 cases in each group. The operation time， intraoperative blood loss， anal exhaust time， hospitalization time and complication rate of the two groups were compared. The levels of CD3+， CD4+， CD8+， TNF-α and IL-6 in peripheral blood of patients before and after operation were compared. Results The operation time of the laparoscopic group was （154.91±18.63） min， which was longer than that of the laparotomy group [（141.31 ±15.81）min]， with statistically significant difference（P<0.05）. The intraoperative blood loss [（126.13±30.52）mL vs. （240.72±43.81）mL]， hospitalization time [（8.91±1.61）d vs. （11.41±2.01） d] and exhaust time[（3.22±0.82） d vs. （4.12±1.11）d] were significantly lower in the laparoscopic group than those in the laparotomy group， with statistically significant differences （P<0.05）.The postoperative complication rate of the laparoscopic group was 5.00%， which was slightly lower than that of the laparotomy group（13.33%），with no statistically significant difference（P>0.05）.The levels of CD3+， CD4+， CD4+/CD8+ were significantly higher in the laparoscopic group than those in laparotomy group（P<0.05），while the levels of CD8+， serum TNF-α and IL-6 were significantly lower in the laparoscopic group than those in laparotomy group，with statistically significant differences（P<0.05）. Conclusion Laparoscopic surgery for benign ovarian tumors has the advantages of fewer traumas， quick postoperative recovery and less influence on the immune function of patients.

[Key words] Laparoscopy; Benign ovarian tumor; T lymphocyte; Tumor necrosis factor-α; Interleukin-6

卵巢良性肿瘤是女性患者最为常见的疾病，近年来发病率呈现逐年升高的趋势，但是早期良性卵巢肿瘤临床体征不明显，患者常无法及时就医，因此可能延误临床治疗，部分患者可能转变为恶性肿瘤，严重威胁患者生命安全[1]。目前临床对于卵巢良性肿瘤主要的治疗方案是手术切除，常规的开放性手术对患者创伤大，术后并发症较多，伴随微创理念和器械的飞速发展，腹腔镜技术在妇产科中得到了越来越广泛的应用，该类手术服切口小，患者恢复快，可以在一定程度上减轻患者应激反应程度，但是临床对于不同手术方案治疗良性卵巢肿瘤对患者体内免疫指标和炎症反应变化的影响，临床报道相对较少。为此本研究观察腹腔镜手术治疗良性卵巢肿瘤的效果及对患者外周血T淋巴细胞亚群、血清肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）的影响，为临床卵巢良性肿瘤的治疗提供理论依据，现报道如下。

1 资料与方法

1.1 一般资料

选取我院2015年1月至2018年12月拟实施手术治疗的卵巢良性肿瘤患者120例进行研究，依据Excel 2007生成随机数字进行分组，分为腹腔镜组和开腹组，每组各60例。腹腔镜组，年龄38～65岁，平均（50.8±8.2）岁，肿瘤体积（7.0±1.6）cm3，病理学类型：浆液性囊腺瘤33例、黏液性囊腺瘤18例、成熟畸胎瘤9例。开腹组年龄36～65岁，平均（49.6±7.0）岁，肿瘤体积（6.8±1.3）cm3，病理学类型：浆液性囊腺瘤36例、黏液性囊腺瘤16例、成熟畸胎瘤8例。……