红细胞压积与白蛋白差值在继发性腹腔感染患者病程中的变化  

Changes of the Difference between Hematocrit and Albumin in the Course of Secondary Abdominal Infection

作　　者：许汪斌[1] 代冬梅[1] 何美娥 肖李乐云[1] 王飞[1] 杨磊[1] 唐坤[1] XU Wang-bin;DAI Dong-mei;HE Mei-e;XIAO LI Le-yun;WANG Fei;YANG Lei;TANG Kun(Dept.of Intensive Care Unit,The First Affiliated Hospital of Kunming Medical University,Kunming Yunnan 650032;Dept.of Intensive Care Unit,Qujing Second People’s Hospital,Qujing Yunnan 655000,China)

机构地区：[1]昆明医科大学第一附属医院重症医学科,云南昆明650032 [2]曲靖市第二人民医院重症医学科,云南曲靖655000

出　　处：《昆明医科大学学报》2021年第5期101-106,共6页Journal of Kunming Medical University

基　　金：云南省科技计划重大科技专项(生物医药)基金资助项目(2018ZF009)。

摘　　要：目的通过观察HCT和ALB差值在腹腔感染患者治疗过程中的变化,为腹腔感染患者的准确治疗提供一定的指导。方法选取2018年1月至2018年12月昆明医科大学第一附属医院收治的各类腹腔感染手术患者共计106名,按手术时间分为术前、术后12 h、术后1 d术后2 d、术后7 d、术后14 d和术后21 d 7组(n=106),记录患者性别、年龄;收集患者上述各时间点患者的红细胞压积、血浆白蛋白,计算HCTALB差值。再根据临床结局分为术后好转组和死亡组。比较每组HCT、ALB和HCT-ALB差值。结果与手术前相比,术后12 h、术后1 d、术后2 d和术后7 d,患者HCT和ALB下降,HCT-ALB增大(P<0.05);与手术前相比,术后14 d,HCT和ALB下降,(P<0.05),HCT-ALB差异无统计学意义(P>0.05);与好转组相比,死亡组患者年龄增加(P<0.05),术前的HCT-ALB增大(P<0.05)。结论腹腔感染患者在手术治疗后毛细血管渗漏加重,这一病理过程可持续7 d以上,死亡患者的毛细血管渗漏更严重。Objective To provide the certain guidance for the accurate treatment of patients with abdominal infection by observing the changes of the difference between HCT and ALB in the treatment of patients with abdominal infection.Methods A total of 106 patients with various abdominal infection treated in the First Affiliated Hospital of Kunming Medical University from January 2018 to December 2018 were selected and divided into 7 groups(n=106)according to the operation time:preoperative,postoperative 12 h,postoperative 1 day,postoperative 2 days,postoperative 7 days,postoperative 14 days and postoperative 21 days.Gender and age of patients were recorded.The hematocrit and plasma albumin of patients at each time point above were collected,and the HCT-ALB difference was calculated.According to the clinical outcome,they were divided into the postoperative improvement group and the death group.The difference of HCT,ALB and HCT-ALB in each group was compared.Results Compared with those before the surgery,HCT and ALB decreased and HCT-ALB increased 12 h,1 day,2 days and 7 days after the surgery(P<0.05).Compared with those before the operation,HCT and ALB decreased 14 days after the operation(P<0.05),but there was no significant difference in HCT-ALB(P>0.05).Compared with the improved group,the age of patients in the death group increased(P<0.05),and the preoperative HCT-ALB increased(P<0.05).Conclusion Capillary leakage is aggravated in patients with celiac infection after the surgical treatment,and the pathological process lasts for more than 7 days,and the capillaries of the dead are more leaky.

关 键 词：红细胞压积 血浆白蛋白 腹腔感染 毛细血管渗漏 

分 类 号：R320.1160[医药卫生—人体解剖和组织胚胎学]