白蛋白支持治疗在老年口腔癌患者围手术期的应用:一项回顾性研究  

The application of perioperative albumin support therapy for the elder in the resection of oral cancer:a retrospective study

作　　者：林道炜[1] 韩智晓[1] 朱晓秋 黄志权[2] 徐辉[1] Lin Daowei;Han Zhixiao;Zhu Xiaoqiu;Huang Zhiquan;Xu Hui(Department of Anesthesiology,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou 510120,China;Department of Oral and Maxillofacial Surgery,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou 510120,China)

机构地区：[1]中山大学孙逸仙纪念医院麻醉科,广州510120 [2]中山大学孙逸仙纪念医院口腔颌面外科,广州510120

出　　处：《中华口腔医学研究杂志（电子版）》2020年第6期361-366,共6页Chinese Journal of Stomatological Research(Electronic Edition)

基　　金：广东省自然科学基金(2019A1515011932)。

摘　　要：目的回顾性分析围手术期使用白蛋白对老年口腔癌患者术后康复的影响。方法选取2014年1月至2018年12月期间,在中山大学孙逸仙纪念医院口腔颌面外科行口腔癌根治并行皮瓣修复重建的老年患者(年龄>65岁)217例,按围手术期是否使用白蛋白分成两组:对照组(82例)和白蛋白组(135例),对两组患者围手术期输血量、补液量、术后第3天血清白蛋白水平、术后局部和全身并发症的发生率及住院时间进行比较。采用SPSS 20.0软件包对数据进行统计学分析。结果白蛋白组围手术期晶体液的输注量为(3753.8±286.6)mL,较对照组[(4657.3±326.8)mL]减少,差异有统计学意义(t=98.3,P<0.001);术后第3天白蛋白组血清白蛋白水平[(30.5±4.3)g/L]较对照组[(26.6±4.8)g/L]显著升高,差异有统计学意义(t=-4.04,P<0.001);白蛋白组术后局部并发症的发生率为12.0%,较对照组(26.8%)显著降低,差异有统计学意义(χ~2=8.91,P=0.003);白蛋白组术后住院时间[(13.7±4.9)d]较对照组[(16.5±6.4)d]显著缩短,差异有统计学意义(t=4.48,P<0.001)。结论对于行口腔癌根治并行皮瓣修复重建的老年患者围手术期使用白蛋白支持治疗是一种有效的治疗方法,可降低术后并发症,缩短住院时间,加快患者的康复。Objective Retrospectively analysis to evaluate the effect of perioperative use of albumin on the prognosis of elderly patients with oral cancer resection.Methods A total of 217 elderly patients(age>65 years)who underwent radical resection of oral cancer and autologous skin flap reconstruction were selected in the Department of Oral and Maxillofacial surgery of Sun Yat-sen Memorial Hospital from January 2014 to December 2018.They were divided into two groups according to whether albumin was used during perioperative period:the Control group(n=82)and the Albumin group(n=135).Perioperative blood transfusion volume,fluid transfusion volume,serum albumin level on the third postoperative day,the incidence of local and systemic complications,and duration of hospital stay were compared between the two groups.SPSS 20.0 software was used for the statistical analysis.Results The volume of perioperative crystal fluid infusion was significantly reduced in the Albumin group[(3753.8±286.6)mL]compared with the Control group[(4657.3±326.8)mL,t=98.3,P<0.001].The serum albumin level of patients in the Albumin group[(30.5±4.3)g/L]was significantly higher than that of theControl group[(26.6±4.8)g/L]on the third day after surgery[t=-4.04,P<0.001].Compared with theControl group(26.8%),the incidence of postoperative local complications in the Albumin group(12.0%)was significantly reduced(χ~2=8.91,P=0.003).Compared with the Control group[(16.5±6.4)d],the postoperative hospital stay in the Albumin group[(13.7±4.9)d]was significantly shorter[t=4.48,P<0.001].Conclusions The perioperative albumin support therapy for the elderly patients with oral cancer resection and flap reconstruction was an effective therapy to reduce the postoperative complications andduration of hospital stay,and facilitate enhanced recovery after surgery.

关 键 词：老年人 白蛋白类 口腔肿瘤 预后 

分 类 号：R739.8[医药卫生—肿瘤]