普外科重症患者血浆白蛋白水平变化与预后的关系

[目的]探讨普外科重症患者血浆白蛋白(ALB)水平变化及与预后的关系.[方法]2006年7月至2010年5月在本院住院治疗的47例普外科重症患者临床资料,对手术前后血清ALB水平的变化进行分析,并将术前水平与健康对照组( n =25)进行比较.[结果]普外科重症患者术前ALB水平明显低于正常人(31.62±5.08VS39.67±3.35);术后患者血清ALB水平明显低于术前(26.74±4.81VS31.62±5.08);术后低ALB血症发生率也明显高于术前(95.74%VS65.96%),重症患者手术前血清ALB水平死亡组低于生存组(27.57±5.03VS32.45±3.29),手术后也低于生存组(22.49±4.79VS27.61±5.12),差异均有统计学意义( P <0.05).[结论]低ALB血症广泛存在于重症患者中;大手术可致血清ALB水平进一步下降;血清ALB水平可作为估计重症患者病情预后的指标;临床应加强对大手术重症患者低ALB血症的防治工作.

Correlation of the Changes of Plasma Albumin Level with the Prognosis of Severe Patients in General Surgery Department

[Objective] To analyze the changes of plasma albumin level in severe patients in general surgery department and explore its relationship with the prognosis. [Methods] The clinical data of 47 hospitalized se- vere patients from July 2006 to May in our general surgery department were retrospectively analyzed. The changes of plasma albumin level before and after surgery were analyzed [Results] Before surgery, the albumin level in severe patients was significantly lower than that in the normal people（ P 〈0.05）. The albumin level in patients after surgery was significantly lower than that before surgery（ P 〈0.05）. The incidence of hypoalbu- minemia after surgery was significantly lower than that before surgery（ P 〈0.05）. The albumin level in severe patients of the death group was significantly lower than that in the survival group before and after surgery, and there was significant difference（ P 〈0.05）. [Conclusion] Hypoproteinemia is common in severe patients. Ma- jor surgery can further decrease the albumin level. Plasma albumin may be regarded as a prognostic index of pathogenetic condition in severe patients. It is important to strengthen prevention and cure of hypoproteinemia in severe patients undergoing major surgery.