微血管游离皮瓣重建术后围手术期补充白蛋白对放射性骨坏死患者临床影响的回顾性研究  

Clinic Impact of Perioperative Albumin Supplementation In Osteoradionecrosis Patients Following Microvascular Free Flap Reconstruction--ARetrospective Study

作　　者：李瑾[1] 林慧君 徐辉[1] 林道炜[1] LI Jin;LIN Hui-jun;XU Hui;LIN Dao-wei(Department of Anesthesiology,Sun Yat-Sen Memorial Hospital,Sun Yat-Sen University,510120)

机构地区：[1]中山大学孙逸仙纪念医院麻醉科,510120

出　　处：《岭南急诊医学杂志》2023年第6期568-570,579,共4页Lingnan Journal of Emergency Medicine

摘　　要：目的:回顾性分析围术期补充白蛋白对放射性骨坏死患者行微血管游离瓣重建手术的临床影响。方法:回顾性分析2014年1月至2018年12月在我院口腔科行微血管游离瓣重建手术的放射性骨坏死的117名患者病历资料。其中围术期没有使用白蛋白的患者(CON组)55人,围术期使用白蛋白的患者(ASL组)62人。比较两组围术期的相关情况、术后第3天血红蛋白和血清白蛋白水平、术后并发症、术后住院时间、术后补液量、二次手术率。结果:比较补充白蛋白的患者术后住院时间明显缩短(20.0[17.25-22.75]vs.25.0[19.00-28.00],P<0.05),调整后的几率比(OR)为0.31(95%置信区间(CI)为0.14至0.69,P<0.05)。补充白蛋白的患者术后局部并发症明显减少(9.68%vs.40.00%,P<0.05),而补充白蛋白对全身并发症没有影响。此外,补充白蛋白可明显降低二次手术的发生率(8.1%vs.34.6%,P<0.05)。术后24小时,白蛋白组的总输液量明显低于对照组[(2461.98±881.86)ml vs(2836.45±1045.54)ml,P<0.05]。结论:围手术期补充白蛋白缩短住院时间、降低术后局部并发症发生率、减少二次手术率及术后24小时输液总量。Objective:To retrospectively analyze the clinical effects of perioperative albumin supplementation on patients with radiolucent osteonecrosis undergoing microvascular free flap reconstruction surgery.Methods:The medical records of 117 patients with radiolucent osteonecrosis who underwent microvascular free flap reconstruction surgery in the Department of Stomatology of our hospital from January 2014 to December 2018 were retrospectively analyzed.Among them,there were 55 patients who did not use albumin perioperatively(CON group)and 62 patients who used albumin perioperatively(ASL group).The perioperative correlates,postoperative hemoglobin and serum albumin levels on post-operative day 3,postoperative complications,postoperative length of hospital stay,postoperative rehydration,and rate of secondary surgery were compared between the two groups.Results:Postoperative hospitalization was significantly shorter in patients comparing albumin supplementation(20.0[17.25-22.75]vs.25.0[19.00-28.00],P<0.05),with an adjusted odds ratio(OR)of 0.31(95%confidence interval(CI)0.14 to 0.69,P<0.05).Patients supplemented with al-bumin had significantly fewer postoperative local complications(9.68%vs.40.00%,P<0.05),whereas albumin supple-mentation had no effect on systemic complications.In addition,albumin supplementation significantly reduced the inci-dence of secondary surgery(8.1%vs.34.6%,P<0.05).At 24 hours postoperatively,the total infusion volume in the al-bumin group was significantly lower than that in the control group[(2461.98±881.86)ml vs.(2836.45±1045.54)ml,P<0.05].Conclusion:Perioperative albumin supplementation shortens hospitalization time,reduces the incidence of postoperative local complications,and decreases the rate of secondary surgery and the total amount of fluids infused in the 24-hour postoperative period.

关 键 词：白蛋白 放射性骨坏死 围手术期 住院时长 

分 类 号：R730.55[医药卫生—肿瘤]