CAJ | 학술논문

目的：研究胃肠术后血清白蛋白浓度的影响与预测因素。方法：通过相关和回归的检测方法研究159例胃肠手术后的患者的血清白蛋白浓度与11个临床因素之间的关系。结果：血清白蛋白浓度在术后6~12 h有显著的下降（P<0.01）；相关性分析显示术后血清白蛋白浓度（22.62±4.59）g/L依次与术前血红蛋白浓度（P<0.01）、前白蛋白浓度（P=0.009）及白蛋白浓度（P=0.021）呈正相关，与术中净入液体量比体重（P<0.01）、手术时间（P=0.002）及术中净失血浆量比体重（P=0.004）呈负相关。多元线性回归分析显示术后血清白蛋白浓度（Y，g/L）与术前血红蛋白浓度（X1，g/L）、术中净入液体量比体重（X2，mL/kg）及术中净失血浆量比体重（X3，mL/kg）之间的回归方程为：Y=0.052X1-0.081X2-0.411X3+21.243。结论：血浆白蛋白浓度在胃肠大中手术后6~12 h有显著下降。术前血红蛋白浓度、术前前白蛋白浓度、术前白蛋白浓度、术中净入液体量比体重、手术时间及术中净失血浆量比体重是术后血清白蛋白浓度的影响因素；其中，术中净入液体量比体重、术中净失血浆量比体重及术前血红蛋白浓度是术后血清白蛋白浓度的预测因素。
목적：연구위장술후혈청백단백농도적영향여예측인소。방법：통과상관화회귀적검측방법연구159례위장수술후적환자적혈청백단백농도여11개림상인소지간적관계。결과：혈청백단백농도재술후6~12 h유현저적하강（P<0.01）；상관성분석현시술후혈청백단백농도（22.62±4.59）g/L의차여술전혈홍단백농도（P<0.01）、전백단백농도（P=0.009）급백단백농도（P=0.021）정정상관，여술중정입액체량비체중（P<0.01）、수술시간（P=0.002）급술중정실혈장량비체중（P=0.004）정부상관。다원선성회귀분석현시술후혈청백단백농도（Y，g/L）여술전혈홍단백농도（X1，g/L）、술중정입액체량비체중（X2，mL/kg）급술중정실혈장량비체중（X3，mL/kg）지간적회귀방정위：Y=0.052X1-0.081X2-0.411X3+21.243。결론：혈장백단백농도재위장대중수술후6~12 h유현저하강。술전혈홍단백농도、술전전백단백농도、술전백단백농도、술중정입액체량비체중、수술시간급술중정실혈장량비체중시술후혈청백단백농도적영향인소；기중，술중정입액체량비체중、술중정실혈장량비체중급술전혈홍단백농도시술후혈청백단백농도적예측인소。
Objective:To identify the influencing and predictive factors of postoperative serum albumin level following gastrointestinal surgery. Method:12 clinical factors and the postoperative serum albumin level of 159 patients undergoing gastrointestinal surgery were investigated. The clinical factors were tested for the correlation and regression with the postoperative serum albumin level. Result:Serum albumin level had a significant decrease in 6 to 12 hours after operations(P<0.01). The postoperative serum albumin level(22.62±4.59)g/L was statistically positively correlative with preoperative level of hemoglobin(P<0.01),pre-albumin(P=0.009) and albumin(P=0.021),and was negatively correlative with intraoperative gain of fluid per kilogram of body weight(P<0.01),operative duration(P=0.002)and intraoperative net loss of plasma per kilogram of body weight(P=0.004), in sequence. The regression equation for postoperative serum albumin level(Y,g/L),preoperative level of hemoglobin(X1,g/L),intraoperative gain of fluid per kilogram of body weight(X2,mL/kg) and intraoperative net loss of plasma per kilogram of body weight(X3,mL/kg) was Y=0.052X1-0.081X2-0.411X3 +21.243. Conclusion:The serum albumin level has a striking decrease in 6 to 12 hours after major or moderate gastrointestinal operations. The preoperative level of hemoglobin,pre-albumin and albumin,the intraoperative gain of fluid per kilogram of body weight,operative duration and intraoperative net loss of plasma per kilogram of body weight are influencing factors of postoperative serum albumin level. The intraoperative net loss of plasma per kilogram of body weight,intraoperative gain of fluid per kilogram of body weight and preoperative level of hemoglobin are predictive factors of postoperative serum albumin level.