Jiang Siyuan, Zhang Jin
First Department of Anesthesiology, Shengjing Hospital of China Medical University, Shenyang 110000, Liaoning, China. Corresponding author: Zhang Jin, Email:
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2017 Mar;29(3):284-288. doi: 10.3760/cma.j.issn.2095-4352.2017.03.020.
After major operation, a series of complicated pathological and physiological changes will occur during the trauma and stress state. The protein synthesis is affected, which results in negative nitrogen balance. In addition, the release of inflammatory factors can damage the capillary endothelial cells and increase the permeability of micrangium, induce vascular colloidal albumin leakage to the extravascular tissue, decrease plasma albumin, make wound edema, eventually lead to postoperative hypoproteinemia. Except for albumin supplement, it should be aimed at the mechanism to control the stress response and reduce the leakage caused by the release of inflammatory factors to solve this problem radically in clinical work. The reports about the causes and treatment of hypoproteinemia after major surgery were reviewed to provide evidence for clinical treatment.
大手术后，在创伤和应激状态下会发生一系列复杂的病理生理变化。蛋白质合成受到影响，导致负氮平衡。此外，炎症因子的释放可损伤毛细血管内皮细胞，增加微血管通透性，促使血管内胶体白蛋白渗漏到血管外组织，降低血浆白蛋白水平，造成伤口水肿，最终导致术后低蛋白血症。在临床工作中，除补充白蛋白外，应针对其机制控制应激反应，减少炎症因子释放所致的渗漏，从根本上解决这一问题。本文综述了有关大手术后低蛋白血症的病因及治疗的报道，为临床治疗提供依据。
