结直肠癌围手术期低蛋白血症的研究进展  

Research Progress of Perioperative Hypoproteinemia in Colorectal Cancer

作　　者：李亚萍[1] 寇志坚 阎文军[1] LI Yaping;KOU Zhijian;YAN Wenjun(The People's Hospital of Gansu Province,Lanzhou 730000,China;不详)

机构地区：[1]甘肃省人民医院,甘肃兰州730000

出　　处：《中国医学创新》2023年第7期182-188,共7页Medical Innovation of China

基　　金：甘肃省科学技术厅自然科学基金(21JR7RA627)。

摘　　要：结直肠癌围手术期低蛋白血症发生率高,易导致血浆胶体渗透压下降、组织灌注减少,引起感染,增加术后吻合口瘘的发生率,甚至引发急性肾损伤等严重并发症。结直肠癌术后发生低蛋白血症的原因众多,针对低蛋白血症的治疗,临床通过谨慎补充白蛋白,营养风险筛查与营养评定,并对高风险患者术前给予营养支持,同时在术后早期启动肠内营养方案,能有效提高患者术后白蛋白水平,减少并发症的发生,显著改善患者预后。另外,合理的药物、麻醉与术式的选择能够减少炎性因子释放、减轻应激反应、降低毛细血管通透性、进而减少白蛋白渗漏,是防治结直肠癌术后低蛋白血症的有效措施。Colorectal cancer has a high incidence of perioperative hypoproteinemia, which easily leads to decreased plasma colloid osmotic pressure, decreased tissue perfusion, infection, increased incidence of postoperative anastomotic leakage, and even causes serious complications such as acute kidney injury. There are many reasons of hypoproteinemia after colorectal cancer surgery. For the treatment of hypoproteinemia, careful albumin supplementation, nutritional risk screening and nutritional assessment, preoperative nutritional support for high-risk patients and early postoperative enteral nutrition program can effectively improve the postoperative albumin level, reduce the occurrence of complications and significantly improve the prognosis of patients. In addition, reasonable drugs, anesthesia and surgical selection can reduce the release of inflammatory factors, reduce stress response, reduce capillary permeability, and then reduce albumin leakage, which is an effective measure to prevent and treat hypoproteinemia after colorectal cancer surgery.

关 键 词：结直肠癌 低蛋白血症 应激 炎症反应 围手术期 

分 类 号：R735.34[医药卫生—肿瘤]