目的 评价腹腔镜和开腹手术对子宫内膜癌患者免疫功能的影响.方法 选取2015年7月至2016年7月于吉林省肿瘤医院住院并接受手术治疗的子宫内膜癌患者58例为研究对象,依从患者意愿,32例行腹腔镜手术(腹腔镜组),26例行开腹手术(开腹组).比较两组患者手术一般情况(手术时间、术中出血量、住院天数)及术后第1天、术后第5天白细胞计数、白介素-6(interleukin,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)及C反应蛋白(C-reactive protein,CRP)水平.结果 腹腔镜组患者术中出血量显著少于开腹组(P<0.05),手术时间和住院天数均显著短于开腹组(P<0.05).术后第1天,两组患者白细胞计数、IL-6、TNF-α及CRP水平较术前均显著升高(P<0.05),且开腹组患者上述指标升高幅度显著大于腹腔镜组(P<0.05);术后第5天,两组患者白细胞计数、IL-6、TNF-α及CRP水平较术后第1天均显著下降(P<0.05),且腹腔镜组患者上述指标下降幅度均显著大于开腹组(P<0.05).结论 腹腔镜手术治疗子宫内膜癌较开腹手术对患者免疫功能影响更小.%Objective To estimate the effect of laparoscopic and open abdominal surgery on the immune function of patients with endometrial carcinoma.Method 58 patients with endometrial carcinoma received surgery treatment in Jilin Cancer Hospital from July 2015 to July 2016 were selected as the research objects, 32 cases underwent laparoscopic surgery group (laparoscope group) and 26 cases underwent laparotomy (laparotomy group). The general situation (surgical time, amount of blood in the operation and length of hospital stay), the count of white blood cells and the levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and C-reactive protein (CRP) 1 day after surgery and 5 days after surgery were compared between the two groups.Result The surgical time and length of hospital stay in laparoscope group were significantly shorter than those of laparotomy group (P<0.05), the amount of blood in the operation in laparoscope group was significantly less than that of laparotomy group (P<0.05). 1 day after surgery, the count of white blood cells and the levels of IL-6, TNF-α and CRP of the two groups increased significantly compared with before surgery (P<0.05), and the laparotomy group increased significantly greater than laparoscope group (P<0.05). 5 days after surgery, the count of white blood cells and the levels of IL-6, TNF-α and CRP of the two groups decreased significantly compared with 1 day after surgery (P<0.05), and the laparoscope group decreased significantly greater than laparotomy group (P<0.05).Conclusion Compared with laparotomy, laparoscope provides a less influence on immune function for patients with endometrial carcinoma.
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