CAJ | 학술논문

目的探讨不同腹部手术后早期是否存在血浆白蛋白含量降低及术后早期血浆白蛋白含量变化是否与炎症介质水平相关.方法选取2008年8月至2009年3月择期行不同腹部手术的患者45例,按手术方式不同将患者分为胆囊切除组(A组)、胆囊切除+胆道探查组(B组)、消化道肿瘤根治切除组(C组).每组均为15例.3组于术前、术后12、24、48 h及72 h测定血浆白蛋白含量、血清IL-6、TNF-α浓度.结果白蛋白含量:A组术后各检测时间点较术前无明显降低(P＞0.05);术后各检测时间点B、C组患者血浆白蛋白含量较术前降低(P＜0.01),C组下降更明显.血清IL-6、TNF-α:A组患者术后12、24、48 h较术前升高(P＜0.01);B、C组患者术后各检测时间点较术前升高(P＜0.01);术前3组间比较差异无统计学意义(P＞0.05).术后各检测时间点3组间比较差异有统计学意义(P＜0.01).血浆白蛋白含量与IL-6、TNF-α浓度呈负相关;(r=-0.376,P=0.000;r=-0.772,P=0.000).结论腹部中大手术后早期患者出现血浆白蛋白含量降低;腹部手术后早期炎症介质有不同程度的升高;腹部手术后早期白蛋白含量与炎症介质浓度呈负相关.
목적 탐토불동복부수술후조기시부존재혈장백단백함량강저급술후조기혈장백단백함량변화시부여염증개질수평상관.방법 선취2008년8월지2009년3월택기행불동복부수술적환자45례,안수술방식불동장환자분위담낭절제조(A조)、담낭절제+담도탐사조(B조)、소화도종류근치절제조(C조).매조균위15례.3조우술전、술후12、24、48 h급72 h측정혈장백단백함량、혈청IL-6、TNF-α농도.결과 백단백함량:A조술후각검측시간점교술전무명현강저(P＞0.05);술후각검측시간점B、C조환자혈장백단백함량교술전강저(P＜0.01),C조하강경명현.혈청IL-6、TNF-α:A조환자술후12、24、48 h교술전승고(P＜0.01);B、C조환자술후각검측시간점교술전승고(P＜0.01);술전3조간비교차이무통계학의의(P＞0.05).술후각검측시간점3조간비교차이유통계학의의(P＜0.01).혈장백단백함량여IL-6、TNF-α농도정부상관;(r=-0.376,P=0.000;r=-0.772,P=0.000).결론 복부중대수술후조기환자출현혈장백단백함량강저;복부수술후조기염증개질유불동정도적승고;복부수술후조기백단백함량여염증개질농도정부상관.
Objective To probe the changes of plasma albumin concentration and its correlation with that of blood inflammatory factors at the postoperative early stage in patients undergoing intraabdominal surgery. Methods From August 2008 to March 2009, 45 patients undergoing abdominal surgery were divided into three groups according to different types of operation with 15 cases in each group, cholecystectomy group( A), chole cystectomy plus common bile duct exploration group(B) and radical resection of alimentary duct maliguance group (C). Before the surgery and 12,24,48,72 h after operation, plasma albumin contentserum IL-6 and TNF-α concentration were measured. Results Postoperatively the content of plasma albumin did not change significantly in group A ( P ＞ 0.05 ), while that decreased after operation in group B and group C(P ＜0.01 ). The postoperative concentration of serum IL-6 and TNF-α increased in group A at 12, 24 h and 48 h after operation(P ＜0.01 ). In group B and group C IL-6 and TNF-α increased at all tested time point after operation ( P ＜ 0.01 ). The postoperative alterations of IL-6 and TNF-α were statistically different between the three groups at all time points(P ＜0.01 ). The content of plasma albumin was in a negative correlation with the concentration of IL-6 and TNF-α; ( r = - 0.376, P = 0.000; r =-0.772,P = 0.000). Conclusions The content of plasma albumin decreased at the early stage after major and moderate abdominal surgery. The content of plasma albumin was in a negative correlation with the concentration of inflammatory factors at the early stage after abdominal surgery.