大手术患者血液蛋白水平的变化及其临床意义

目的研究大手术重症患者血液蛋白水平的变化,并探讨其临床意义。方法分析42例大手术重症患者手术前后血液血红蛋白(HGB)、清蛋白(ALB)、前清蛋白(PA)、转铁蛋白(TRF)、免疫球蛋白(IgA、IgG、IgM)的变化,并与50例正常人进行比较。结果大手术患者手术前除ALB显著低于对照组外,与对照组比较无显著性差异;术后当天除HGB接近正常外,其他被检测指标都显著低于对照组,8d时除ALB、IgA外,其他被检测指标也恢复到正常水平;术前与术后比较,术后当天ALB、IgA明显低于术前,8d时所有指标与术前比较均无显著性差异;术后组间比较,所有指标均无显著性差异。结论低蛋白血症广泛存在于重症患者中;大手术可致血清蛋白水平进一步下降,血清蛋白水平可作为估计重症患者病情预后的指标,加强对大手术重症患者低蛋白血症的防治具有重要的意义。

Changes and Clinical Significance of Blood Protein Level before and after Operation in Major Operation

Objective To study the change and clinical significance of blood protein level before and after operation in the major operation. Methods Haematoglobin(HGB), albumin(ALB), prealbumin(PA), transferring(TRF) and immunoglobulin(IgA, IgG, IgM) of 42 critically ill patients were detected and compared with 50 healthy individuals. Results (1)Compared with the group of normal control, ALB was lower in preoperative critically ill patients, there was no significant difference on HGB, PA, TRF, IgA, IgG, IgM;(2)After operation, there were lower ALB, PA, TRF, IgA, IgG, IgM except HGB in those ill patients on the first day, while ALB, PA, TRF, IgG and IgM reached normal level on the eight day compared with the group of normal control;(3) Lower ALB and IgA in the postoperative patients had statistical differences compared with the preoperative patients on the first day, while there were no significant difference on all indexes;(4) there was no significant difference on HGB, ALB, PA, TRF, IgA, IgG and IgM after operation. Conclusions In critically ill patients, there could be a Hypoproteinemia state, while blood protein level decease greatly after operation and some blood protein levels are regarded as prognostic indexes of pathogenetic condition, it is important to strengthen prevention and cure of Hypoproteinemia.