胃肠手术后血清白蛋白浓度的影响与预测因素  

Influencing and Predictive Factors of Postoperative Serum Albumin Level Following Gastrointestinal Surgery

作　　者：袁锡裕[1] 叶根榕[1] 黎曙练[1] 曾沛强[1] 李瑞平[1] 吴泽建[1] 

机构地区：[1]广东省东莞市人民医院,广东东莞523000

出　　处：《中国医学创新》2014年第3期21-23,共3页Medical Innovation of China

基　　金：东莞市科研项目(20131051010118)

摘　　要：目的：研究胃肠术后血清白蛋白浓度的影响与预测因素。方法：通过相关和回归的检测方法研究159例胃肠手术后的患者的血清白蛋白浓度与11个临床因素之间的关系。结果：血清白蛋白浓度在术后6~12 h有显著的下降（P〈0.01）；相关性分析显示术后血清白蛋白浓度（22.62±4.59）g/L依次与术前血红蛋白浓度（P〈0.01）、前白蛋白浓度（P=0.009）及白蛋白浓度（P=0.021）呈正相关，与术中净入液体量比体重（P〈0.01）、手术时间（P=0.002）及术中净失血浆量比体重（P=0.004）呈负相关。多元线性回归分析显示术后血清白蛋白浓度（Y，g/L）与术前血红蛋白浓度（X1，g/L）、术中净入液体量比体重（X2，mL/kg）及术中净失血浆量比体重（X3，mL/kg）之间的回归方程为：Y=0.052X1-0.081X2-0.411X3＋21.243。结论：血浆白蛋白浓度在胃肠大中手术后6~12 h有显著下降。术前血红蛋白浓度、术前前白蛋白浓度、术前白蛋白浓度、术中净入液体量比体重、手术时间及术中净失血浆量比体重是术后血清白蛋白浓度的影响因素；其中，术中净入液体量比体重、术中净失血浆量比体重及术前血红蛋白浓度是术后血清白蛋白浓度的预测因素。Objective：To identify the influencing and predictive factors of postoperative serum albumin level following gastrointestinal surgery. Method：12 clinical factors and the postoperative serum albumin level of 159 patients undergoing gastrointestinal surgery were investigated. The clinical factors were tested for the correlation and regression with the postoperative serum albumin level. Result：Serum albumin level had a significant decrease in 6 to 12 hours after operations（P〈0.01）. The postoperative serum albumin level（22.62±4.59）g/L was statistically positively correlative with preoperative level of hemoglobin（P〈0.01）,pre-albumin（P=0.009） and albumin（P=0.021）,and was negatively correlative with intraoperative gain of fluid per kilogram of body weight（P〈0.01）,operative duration（P=0.002）and intraoperative net loss of plasma per kilogram of body weight（P=0.004）, in sequence. The regression equation for postoperative serum albumin level（Y,g/L）,preoperative level of hemoglobin（X1,g/L）,intraoperative gain of fluid per kilogram of body weight（X2,mL/kg） and intraoperative net loss of plasma per kilogram of body weight（X3,mL/kg） was Y=0.052X1-0.081X2-0.411X3 ＋21.243. Conclusion：The serum albumin level has a striking decrease in 6 to 12 hours after major or moderate gastrointestinal operations. The preoperative level of hemoglobin,pre-albumin and albumin,the intraoperative gain of fluid per kilogram of body weight,operative duration and intraoperative net loss of plasma per kilogram of body weight are influencing factors of postoperative serum albumin level. The intraoperative net loss of plasma per kilogram of body weight,intraoperative gain of fluid per kilogram of body weight and preoperative level of hemoglobin are predictive factors of postoperative serum albumin level.

关 键 词：影响因素 预测因素 术后 血清白蛋白 胃肠手术 

分 类 号：R656[医药卫生—外科学]