提高老年人胃肠道手术后血清白蛋白水平的临床对照实验  

A CONTROL STUDY ON IMPROVING SERUM ALBUMIN LEVEL AFTER GASTRO-INTESTINAL SURGERY IN THE ELDERLY

作　　者：钱敏[1] 朱捷[1] 

机构地区：[1]华东医院普外科,上海市200040

出　　处：《老年医学与保健》2003年第2期99-100,103,共3页Geriatrics & Health Care

摘　　要：目的探讨一种改善老年人胃肠道大手术后血清白蛋白水平的有效方法。方法90名接受胃肠道切除术的老年病人被随机分成3组,每组30名。对照组术后给予基本的肠外营养;白蛋白(ALB)组每日另增加人体白蛋白10g,共用5天;白蛋白加乌司他丁(ALB+UTI)组则在此基础上,从手术前1天起加用乌司他丁10万IUbid,连用5天。分别测定各组患者术前1天及术后第1、3、5天的血清谷-丙转氨酶(ALT)及白蛋白(Alb)水平,并相比较。结果手术前、后各组的ALT水平差异不大。术后第1天各组的Alb水平较术前均有明显下降,对照组和ALB组的P值<0.01,ALB+UTI组的P值<0.05;术后第3、5天ALB+UTI组的Alb水平明显高于对照组及ALT组,P值均<0.05。结论胃肠道大手术后老年人的血清白蛋白水平有较明显的下降,术后补充小剂量白蛋白的疗效不明显,而在围手术期合用乌司他丁可使老年人术后低白蛋白血症有较明显的改善。Objective To investigate an effective therapy of improving serum albumin after gastro-intestinal surgery in the elderly. Methods Ninety aged patients who received gastro-intestinectomy were randomly divided into 3 groups. The control group received basic parenteral nutrition; Albumin Group was administered human albumin 10g for 5 days; Albumin /Ulinastatin Group was administered Ulinastatin 100,000 IU bid for 5 days from the day before operation in addition. Serum ALT and albumin were obtained before operation and on 1st,3rd,5th day post-operatively. Results The serum level of ALT had no significant change after operation. The level of albumin decreased on the 1st day post-operatively [the control group and Alb Group ( P< 0.01);Alb/UTI Group( P< 0.05)]. On the 3rd and 5th day, compared to other 2 groups, Alb/UTI Group had obviously higher levels of albumin( P< 0.05). Conclusions The serum albumin level of aged patient had an evident decline after gastro-intestinal surgery. Combined use of Ulinastatin and albumin seemed more effective on improving the albumin level than low-dosage albumin supplement in the post-operative aged.

关 键 词：胃肠道手术 血清白蛋白 胃肠外营养 老年人 

分 类 号：R656.6[医药卫生—外科学] R446.112[医药卫生—临床医学]