肝癌患者手术前后清蛋白水平对术后腹腔感染的影响  

Effect of albumin levels pre and post-hepatectomy on intra-abdominal infection

作　　者：姜霞 谷申森 芦雪萍 宋婷婷[1] 吐尔洪江·吐逊[1] 周成明[1] JIANG Xia;GU Shensen;LU Xueping;SONG Tingting;TUERHONGJIANG·Tuxun;ZHOU Chengming(Laparoscopic Surgery of Liver,First Affiliated Hospital of Xinjiang Medical University,Urumqi,Xinjiang 830054,Chin)

机构地区：[1]新疆医科大学第一附属医院肝脏腹腔镜外科,新疆乌鲁木齐830054

出　　处：《国际检验医学杂志》2021年第22期2706-2709,2713,共5页International Journal of Laboratory Medicine

基　　金：新疆维吾尔自治区自然科学基金项目(2017D01C320)。

摘　　要：目的探讨肝癌患者手术前后清蛋白(ALB)水平对术后腹腔感染(IAI)的影响。方法选择2018年6月至2019年12月于该院行肝癌切除术的患者139例。检测患者手术前及手术后血液中清蛋白水平,收集患者临床资料及实验室检查资料;根据患者术后是否发生IAI将患者分为IAI组(37例)和非IAI组(102例),比较两组患者上述资料之间的差异;采用Logistic回归分析手术前后清蛋白水平对术后IAI的影响,并通过受试者工作特征曲线分析手术前后清蛋白水平对术后IAI的预测效能。结果139例患者中有37例术后发生IAI,IAI发生率为26.62%。IAI组术中胆管处理率、手术时长均高于非IAI组,而IAI组手术前后ALB水平均低于非IAI组,两组患者术后ALB水平均较术前下降,差异均有统计学意义(P<0.05)。术中胆管处理(OR=6.857,95%CI:2.362~19.902)及手术时长增加(OR=1.994,95%CI:1.369~2.903)为IAI发生的独立危险因素,而术前高水平ALB(OR=0.812,95%CI:0.719~0.916)是IAI发生的保护因素(P<0.05)。术前ALB对术后IAI的预测价值优于术后ALB(P<0.05),术前ALB预测术后IAI的曲线下面积为0.819(95%CI:0.755~0.887),最佳临界值为33.39 g/L,灵敏度为72.97%,特异度为81.37%。结论术前高水平ALB是IAI发生的保护因素,监测术前ALB水平对IAI的发生具有一定的预测价值。Objective To investigate the effect of albumin(ALB)levels pre and post-hepatectomy on intra-abdominal infection(IAI).Methods A total of 139 patients who underwent liver cancer resection in the hospital from June 2018 to December 2019 were selected.The blood ALB level was measured before and after the operation,and the clinical and laboratory data of the patients were collected.Patients were divided into IAI group(37 cases)and non-IAI group(102 cases)according to whether IAI occurred after operation.Then Logistic regression was used to analyze the effect of ALB levels pre and post-surgery on IAI after hepatectomy,and receiver operator characteristic curve was used to analyze the predictive ability of the above two indicators for postoperative IAI.Results The number of postoperative IAI in 139 patients was 37,and the incidence of IAI was 26.62%.The intraoperative bile duct management rate and the length of operation of patients in IAI group were significantly higher than those in non-IAI group,while the preoperative and postoperative ALB levels were significantly lower than those in non-IAI group.The levels of ALB in 2 groups decreased after surgery compared with those before surgery,and the difference was statistically significant(P<0.05).Intraoperative bile duct management(OR=6.857,95%CI:2.362-19.902)and increased operation duration(OR=1.994,95%CI:1.369-2.903)were independent risk factors that affect the occurrence of IAI,while high level of preoperative ALB(OR=0.812,95%CI:0.719-0.916)was the protective factor affecting the occurrence of IAI(P<0.05).Preoperative ALB level has a certain predictive value for IAI(P<0.05),the area under the curve was 0.819(95%CI:0.755-0.887),the optimal cut-off point was 33.39 g/L,its sensitivity was 72.97%,and its specificity was 81.37%.Conclusion High level of ALB is a protective factor for the occurrence of IAI,and monitoring the preoperative ALB level has certain predictive value for the occurrence of IAI.

关 键 词：肝癌切除术 腹腔感染 清蛋白 

分 类 号：R446.112[医药卫生—诊断学]