Alberti L R, Petroianu A, Zac Renata Indelicato, Andrade J C Cisneiros Guedes
Alfa Institute of Gastroenterology of the Hospital of Clinics of the Federal University of Minas Gerais, Brazil.
Chirurgia (Bucur). 2008 Jan-Feb;103(1):39-43.
To assess the effect of surgical trauma on serum albumin concentration during the immediate postoperative period.
200 consecutive adult patients submitted to elective major surgeries (Group 1) and to medium size surgeries (Group 2) were identified according to gender, age and skin color. Blood samples for the determination of serum albumin concentration were obtained on the day preceding and the one following the surgical procedure. Pre- and postoperative albumin data were compared by the paired t test. The gender was compared by the Student t test. The skin color and the age were compared by the repeated measured one-way ANOVA and the Tukey-Kramer tests. The level of significance was set at P < 0.05.
There was a reduction in serum albumin in Group 1 (p < 0.0001) and Group 2 (p < 0.0001), with no difference between gender or skin colors for major surgeries. However, women showed a lower reduction than men in serum albumin in medium-sized surgeries. In medium-sized surgeries, black patients had the lowest reduction in albuminemia. The greater reduction in albuminemia occurred in patients older than 65 years old.
Medium-sized and majors operations provoked an acute reduction in albuminemia, which was more intense in aged white men.
评估手术创伤对术后即刻血清白蛋白浓度的影响。
根据性别、年龄和肤色确定200例连续接受择期大手术的成年患者（第1组）和中等规模手术的成年患者（第2组）。在手术前一天和手术后一天采集血样以测定血清白蛋白浓度。术前和术后白蛋白数据采用配对t检验进行比较。性别采用Student t检验进行比较。肤色和年龄采用重复测量单因素方差分析和Tukey-Kramer检验进行比较。显著性水平设定为P < 0.05。
第1组（p < 0.0001）和第2组（p < 0.0001）血清白蛋白均降低，大手术患者的性别和肤色之间无差异。然而，在中等规模手术中，女性血清白蛋白的降低幅度低于男性。在中等规模手术中，黑人患者白蛋白血症的降低幅度最小。白蛋白血症降低幅度最大的是年龄超过65岁的患者。
中等规模和大手术可引起白蛋白血症急性降低，老年白人男性降低更为明显。
