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白蛋白输注对胃肠道手术后早期低蛋白血症有益吗?一项前瞻性随机对照试验。

Is albumin administration beneficial in early stage of postoperative hypoalbuminemia following gastrointestinal surgery?: a prospective randomized controlled trial.

作者信息

Yuan Xi-Yu, Zhang Chang-Hua, He Yu-Long, Yuan Yan-Xian, Cai Shi-Rong, Luo Ning-Xiang, Zhan Wen-Hua, Cui Ji

机构信息

Department Gastro-intestinal Pancreatic Surgery, Centre of Gastric Cancer, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China 510080.

出版信息

Am J Surg. 2008 Nov;196(5):751-5. doi: 10.1016/j.amjsurg.2007.10.030. Epub 2008 Jul 23.

Abstract

BACKGROUND

Surgeons commonly see postoperative hypoalbuminemia, but whether exogenous albumin administration is beneficial for these patients is unclear.

METHODS

A prospective, randomized study design was used, allocating 127 hypoalbuminemic patients into the albumin or saline group after gastrointestinal surgery. We investigated the development of postoperative hypoalbuminemia, nutritional status, postoperative fluid balance, postoperative complications, and postoperative hospital stay.

RESULTS

Plasma albumin concentrations of both groups decreased after operations (P <.01). No significant differences were found between groups (P >.05) in changes in postoperative plasma albumin concentration from baseline levels. Postoperative plasma albumin, total protein, and prealbumin levels were similar in the 2 groups. While 3-day and 5-day recovery ratios were similar, 7-day recovery ratios were lower in the albumin group (P <.05). No significant difference was found in overall fluid administration, urine output, or the incidence of postoperative complications between groups (23.4% for albumin group and 12.7% for control group, P = .116).

CONCLUSIONS

Albumin administration in the early stage of postoperative hypoalbuminemia following gastrointestinal surgery is not beneficial in correcting hypoalbuminemia or in clinical outcomes.

摘要

背景

外科医生经常会遇到术后低白蛋白血症,但外源性白蛋白给药对这些患者是否有益尚不清楚。

方法

采用前瞻性随机研究设计,将127例胃肠道手术后的低白蛋白血症患者分为白蛋白组或生理盐水组。我们调查了术后低白蛋白血症的发展、营养状况、术后液体平衡、术后并发症及术后住院时间。

结果

两组患者术后血浆白蛋白浓度均下降(P<.01)。两组术后血浆白蛋白浓度相对于基线水平的变化无显著差异(P>.05)。两组术后血浆白蛋白、总蛋白和前白蛋白水平相似。虽然3天和5天的恢复率相似,但白蛋白组7天的恢复率较低(P<.05)。两组之间在总体液体输入量、尿量或术后并发症发生率方面无显著差异(白蛋白组为23.4%,对照组为12.7%,P=.116)。

结论

胃肠道手术后早期发生低白蛋白血症时给予白蛋白,对纠正低白蛋白血症或临床结局并无益处。

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