Smith P C, Frank H A, Kasdon E J, Dearborn E C, Skillman J J
Ann Surg. 1978 Jan;187(1):31-7. doi: 10.1097/00000658-197801000-00007.
Quantitative changes in albumin and water content which occur in skin and muscle tissue obtained by biopsy from clean surgical incisions at the time of skin incision and at the time of wound closure were assessed in seven patients who had major abdominal and vascular operations. Biopsies from skin, muscle and pulmonary tissue were obtained in a second group of nine patients who had thoracotomy for suspected bronchogenic carcinoma. The intravascular albumin mass decreased linearly with the duration of the operation (r = 0.69, p <0.01) and was correlated significantly with a linear increase of extravascular albumin content in muscle (r = 0.63, p < 0.01). A significant increase of extravascular albumin occurred from the time of incision to the time of wound closure in the skin and muscle samples from both groups (p < 0.05-p < 0.001). Extravascular albumin and water content were assessed in a third group of three postoperative patients who died with acute respiratory failure. Although the concentration of extravascular albumin in pulmonary tissue taken from this group was not different from the thoracotomy group, calculations based on the mean combined post mortem lung weights showed two to three times more extravascular albumin content. The histopathological findings are consistent with these changes. Thoracotomy was not associated with an abnormal increase in pulmonary extravascular albumin and water content, possibly because albumin does not gain access to the pulmonary extravascular space in increased amounts during operation in this clinical setting.
对7例接受腹部和血管大手术的患者，在皮肤切开时和伤口缝合时从清洁手术切口处获取的皮肤和肌肉组织中白蛋白和水分含量的定量变化进行了评估。在第二组9例因疑似支气管源性癌而接受开胸手术的患者中，获取了皮肤、肌肉和肺组织的活检样本。血管内白蛋白量随手术时间呈线性下降（r = 0.69，p <0.01），且与肌肉中血管外白蛋白含量的线性增加显著相关（r = 0.63，p <0.01）。两组患者的皮肤和肌肉样本从切开到伤口缝合时，血管外白蛋白均显著增加（p <0.05 - p <0.001）。对第三组3例术后死于急性呼吸衰竭的患者进行了血管外白蛋白和水分含量评估。尽管该组患者肺组织中血管外白蛋白浓度与开胸手术组无差异，但根据尸检后肺平均重量计算显示，血管外白蛋白含量多出两到三倍。组织病理学结果与这些变化一致。开胸手术与肺血管外白蛋白和水分含量的异常增加无关，可能是因为在这种临床情况下，手术期间白蛋白不会大量进入肺血管外间隙。
