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补充白蛋白在胃肠术后早期低白蛋白血症中的作用:前瞻性随机对照研究

Is albumin administration beneficial in early stage of postoperative hypoalbuminemia after gastrointestinal surgery: a prospective randomized control trial

摘要:

目的 探讨补充外源性白蛋白对胃肠术后低白蛋白血症患者的益处.方法 应用前瞻性随机对照的方法,将127例胃肠术后早期低白蛋白血症的患者,按入组顺序根据随机数字表法随机分配到白蛋白组(64例)和生理盐水组(63例).白蛋白组的受试者从术后当天始每天静脉补充20%人血白蛋白100 ml,连续3 d;生理盐水组以相同剂量补充生理盐水,连续3 d,作为对照.研究比较两组患者术后低蛋白血症的发生、营养状态、液体平衡情况、并发症及住院天数.结果 两组血浆白蛋白水平术后均有显著下降(P<0.05),但两组下降幅度差异无统计学意义(P>0.05).两组术后血浆白蛋白、总蛋白和前白蛋白水平均无明显差异.两组白蛋白3 d和5 d恢复率无明显差异,白蛋白组7 d恢复率明显较低(P<0.05).两组液体总入量和尿量均无显著差异;术后总并发症发生率无显著差异(白蛋白组为23.4%,对照组为12.7%,P=0.116).结论 对胃肠术后早期低白蛋白血症,补充外源性白蛋白对于纠正低白蛋白血症或改善临床结果均无益处.

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abstracts:

Objective To investigate whether albumin administration is beneficial in early stage of postoperative hypoalbuminemia after gastrointestinal surgery. Methods A prospective randomized control trial was designed. One hundred and twenty-seven patients suffered from hypoalbuminemia after gastrointestinal surgery were randomly divided into albumin group (64 cases) and saline group (control group, 63 cases) by using random number form. The albumin group was given 100 ml 20% human albumin daily for 3 days; and in control group, saline 100 ml daily was administered for 3 days after the operation. The disease course of postoperative hypoalbuminemia, nutritional status, complications and hospital stay were compared between the two groups. Results Plasma albumin level in both groups decreased significantly after the operation(P<0.05). No significant differences was found in the change of postoperative plasma albumin level between the two groups (P>0.05). Postoperative plasma albumin, total protein and pre-albumin levels were similar in the two groups. Three-day and 5-day plasma albumin recovery ratios were similar in the two groups, and the 7-day recovery ratio was lower in the albumin group (P<0.05). No significant difference was found in the incidence of postoperative complications between the two groups (23.4% vs. 12.7%, P=0.116). Conclusion Albumin administration in early stage of postoperative hypoalbuminemia following gastrointestinal surgery is not beneficial either in correcting hypoalbuminemia or in clinical outcomes.

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