食管癌患者术后发生低蛋白血症的影响因素及其对临床结局的影响  

Analysis of related factors of postoperative hypoproteinemia in patients with esophageal cancer and its influence on clinical outcomes

作　　者：梁虹艺 黄雪峰 莫泽珣 徐晓玲 王冰 杨琰 袁进 LIANG Hongyi;HUANG Xuefeng;MO Zexun;XU Xiaoling;WANG Bing;YANG Yan;YUAN Jin(Department of Clinical Pharmacy,PLA,Guangzhou 510010,China;Department of Pharmacy,PLA,Guangzhou 510010,China;MICU,General Hospital of Southern Theater Command,PLA,Guangzhou 510010,China;College of Pharmacy,Southern Medical University,Guangzhou 510515,China)

机构地区：[1]中国人民解放军南部战区总医院临床药学科,广东广州510010 [2]中国人民解放军南部战区总医院药剂科,广东广州510010 [3]中国人民解放军南部战区总医院MICU,广东广州510010 [4]南方医科大学药学院,广东广州510515

出　　处：《广东药科大学学报》2021年第3期117-122,共6页Journal of Guangdong Pharmaceutical University

基　　金：广州市科技创新平台开放共享专项(201509010012)。

摘　　要：目的探讨食管癌患者术后发生低蛋白血症的高危因素及其对临床结局的影响,评价术后补充白蛋白的合理性。方法收集2015年1月−2017年12月在南部战区总医院行食管癌手术切除的住院患者的临床资料,按术后检查的血清白蛋白(Alb)值分为研究组(<35 g/L)和对照组(≥35 g/L),单因素分析两组患者一般资料、实验室检查、围术期指标、营养支持情况,比较两组患者住院时间、费用、术后并发症和感染发生率。结果共纳入113例患者,64例(56.64%)术后发生低蛋白血症。两组比较,研究组患者术前腺苷脱氨酶显著升高(P<0.05),住院费用显著增加、术后并发症(42.19%vs 16.32%)和术后感染率(20.31%vs 6.12%)更高(P<0.05);两组均有约90%的患者外源性补充了人血白蛋白,仅研究组出院时Alb较术后有升高(P<0.05),但研究组出院时仍有41例(70.69%)未升至35 g/L以上,对照组仍有34例(77.27%)未恢复至40 g/L以上。结论食管癌患者术后易发生低蛋白血症,对临床结局有不良影响,术后外源性补充人血白蛋白并不能快速纠正低蛋白血症。Objective To explore the high risk factors of postoperative hypoproteinemia in patients with esophagus cancer and its influence on clinical outcomes,and evaluate the rationality of albumin supplement after operation.Methods The clinical data of hospitalized patients who underwent esophageal cancer resection in the General Hospital of Southern Theater from 2015 to 2017 were retrospectively collected.Patients were divided into the study group(<35 g/L)and the control Group(≥35 g/L)according to the serum albumin tested in the second day after surgery.The general data,laboratory tests,perioperative indicators,nutritional support,duration,cost,postoperative complications and infection rate between two groups were analyzed by single factor analysis.Results 64 patients(56.64%)developed hypoproteinemia among 113 patients enrolled.Compared with the control group,patients in the study group had higher adenosine deaminase value before surgery,hospitalization costs,and postoperative complications(42.19%vs 16.32%),and postoperative infection rates(20.31%vs 6.12%).About 90%of the patients in both groups were exogenously supplemented with human albumin,and serum albumin in the study group at discharge was significantly higher than that after surgery(P<0.05).But there were still 70.69%patients did not recover to 35 g/L or more in the study group at discharge,and 77.27%did not recover to 40 g/L or more in the control group at discharge.Conclusion Patients with esophageal cancer are prone to hypoproteinemia after surgery,which has adverse effects on clinical outcomes.Exogenous supplementation of human serum albumin does not rapidly correct hypoproteinemia.

关 键 词：食管癌 低蛋白血症 人血白蛋白 相关因素 临床结局 

分 类 号：R735.1[医药卫生—肿瘤]