喉恶性肿瘤术后早期出现低白蛋白血症的相关因素分析  

Related factors of hypoalbuminemia in early postoperative period after malignant laryngeal tumor surgery

作　　者：黄琦[1] 朱宁 邬振华[1] 项振飞[2] 尤权杰 吴淋蓉 桂意华 任建军 吴园园 HUANG Qi;ZHU Ning;WU Zhenhua(Department of Otolaryngology,Head and Neck Surgery,Ningbo Medical Center Lihuili Hospital,Ningbo 315040,China)

机构地区：[1]宁波市医疗中心李惠利医院耳鼻咽喉头颈外科,浙江宁波315040 [2]宁波市医疗中心李惠利医院放疗科,浙江宁波315040 [3]宁波市宁海县第二医院耳鼻喉科

出　　处：《全科医学临床与教育》2022年第11期977-981,共5页Clinical Education of General Practice

基　　金：浙江省医药卫生项目(2021KY309);宁波市自然科学基金项目(2021J289)。

摘　　要：目的探讨喉恶性肿瘤术后早期发生低白蛋白血症的相关危险因素。方法回顾性分析79例喉恶性肿瘤患者的临床资料,根据术后7 d内是否存在低白蛋白血症分为低白蛋白血症组和正常组,分析两组年龄、肿瘤分期、手术方式、并发症、基础疾病、术前体重指数(BMI)、血生化指标、手术时长、术中出血量、出入量等相关因素,筛选术后早期发生低白蛋白血症的相关危险因素。结果79例喉恶性肿瘤患者后低白蛋白血症发生率为36.71%(29/79)。单因素分析发现低白蛋白血症组和正常组在临床分期、手术方式、颈淋巴结清扫、术前白蛋白、术中出血量、术后平均日鼻饲量上的比较,差异均有统计学意义(χ^(2)分别=21.15、24.11、21.93,OR分别=0.88、1.03、0.99,P均<0.05);多因素分析发现手术方式(全喉切除)、颈淋巴结清扫(双侧)、术后平均日鼻饲量是喉恶性肿瘤术后早期出现低白蛋白血症的影响因素(OR分别=29.24、8.78、0.99,P均<0.05)。结论全喉切除、双侧颈淋巴结清扫、术后平均日鼻饲量与喉恶性肿瘤术后早期低白蛋白血症的发生有关;加强营养支持,做好围手术期营养评估及策略,可降低术后低白蛋白血症发生。Objective To investigate the risk factors of hypoalbuminemia in early postoperative period after malignant laryngeal tumor surgery.Methods The clinical data of 79 patients with malignant laryngeal tumor who underwent laryngectomy were analyzed retrospectively.They were divided into hypoalbuminemia group and normal group according to the hypoalbuminemia within seven days after operation.The related factors as age,tumor stages,surgery methods,complications,basic diseases,preoperative BMI,peri-operative blood biochemical indexes,length of operation,blood loss,average daily fluid intake/output etc were statistically compared between the two groups,thus to screening the risk factors of hypoalbuminemia.Results The incidence of postoperative hypoalbuminemia was 36.71%(29/79).There were significant differences in the clinical stage,surgical methods,neck dissections,preoperative plasma albumin(ALB),blood loss,daily nasal feeding volume between the two groups(χ^(2)=21.15,24.11,21.93,OR=0.88,1.03,0.99,P<0.05).Multivariate analysis found that surgical methods(total laryngectomy),neck dissections(bilateral),and daily nasal feeding volume were risk factors for early postoperative hypoalbuminemia(OR=29.24,8.78,0.99,P<0.05).Conclusion Total laryngectomy,bilateral neck dissections,and daily nasal feeding volume are related to the occurrence of early postoperative hypoalbuminemia after malignant laryngeal tumor surgery.Strengthenning nutritional support and sufficient perioperative nutritional assessment and strategies can reduce the incidence of hypoalbuminemia.

关 键 词：喉恶性肿瘤 低白蛋白血症 营养 并发症 

分 类 号：R739.65[医药卫生—肿瘤]