Usage analysis of human serum albumin in patients with liver cancer and liver cirrhosis after hepatectomy

Linchuang Gandanbing Zazhi

HUANG Donghai¹ 

[1] Department of General Surgery, 180 Hospital of PLA, Quanzhou, Fujian 362000, China;

关键词: liver neoplasms;    liver cirrhosis;    hepatectomy;    serum albumin;   

DOI  :  10.3969/j.issn.1001-5256.2015.06.020

来源: DOAJ

【 摘 要 】

ObjectiveTo analyze the usage of human serum albumin in patients with liver cancer and liver cirrhosis after hepatectomy. MethodsA total of 121 patients with liver cancer and liver cirrhosis who received hepatectomy in our hospital from January 2012 to January 2014 were divided into control group (n=60) and observation group (n=61). Both groups received human serum albumin in addition to the routine treatment for liver protection. The observation group was given intravenous drip of 5% human serum albumin within 48 h after surgery. The plasma albumin concentrations of patients were measured at 48 h after surgery, and if the concentration was ＜35 g/L, the patients would be given 20% human serum albumin until the concentration was ≥35 g/L. The control group was given intravenous drip of 20% human serum albumin within 48 h after surgery until the plasma albumin concentration was ≥35 g/L. The amounts of used human serum albumin and plasma were recorded for both groups. The urine volume, abdominal drainage volume, central venous pressure (CVP), mean arterial pressure (MAP), and thromboelastogram (TEG) R and K values were measured at 1, 3, 7, and 10 days after surgery. The liver function indices before and after surgery and the indocyanine green retention rate at 15 minutes (ICG R15) at 7 days after surgery were measured. Comparison of continuous data between the two groups was made by t test, while comparison of categorical data was made by chisquare test. Results(1) There were no significant differences in age, sex, Child-Pugh classification, surgical approach, intraoperative blood loss, occlusion time of the first porta hepatis, and operation time between the two groups (P＞0.05). But there were significant differences in the amounts of used human serum albumin and plasma and the length of hospital stay between the two groups (P＜0.05). (2) There were significant differences in daily urine volume, CVP, MAP, abdominal drainage volume, and interstitial fluid volume at 1 and 3 days after surgery between the two groups (P＜0.05), but there were no significant differences in the above indices at 7 days after surgerybetween the two groups (P＞0.05). There were no significant differences in alanine aminotransferase, aspartate aminotransferase, total bilirubin, and TEG R and K values at 1 and 3 days after surgery between the two groups (P＞0.05), but significant differences were observed in the above indices at 7 days after surgery (P＜0.05). (3) There was a significant difference in ICGR15 at 7 days after surgery between the observation group and the control group (16.59%±4.4% vs 13.21%±4.2%, t=5.23, P=0.000). ConclusionThe isotonic albumin and hypertonic albumin used in different periods after surgery have a better clinical effect than hypertonic albumin alone.

【 授权许可】

Unknown