低蛋白血症对食管癌、贲门癌根治术预后的影响(1)
【摘 要】目的：探讨围术期低蛋白血症对食管癌、贲门癌根治术预后的影响。方法：回顾性分析2009年1月至2012年6月行食管癌、贲门癌根治手术的174例患者的病例资料。以血清白蛋白(ALB)水平作为分组标准，分别观察术前、术后正常白蛋白组(ALB≥35g/ L)和低白蛋白组(ALB<35g/L)患者在住院时间、监护时间、二次手术、不良预后及并发症发生方面是否存在差异。结果：术前低白蛋白组与正常白蛋白组比较，在各个项目比较中差异无统计学意义(P>0.05)；而术后低白蛋白组与正常白蛋白组无论是在术后住院时间、监护时间、不良预后的发生、二次手术方面还是在肺部并发症、切口感染、吻合口瘘等并发症的发生方面比较差异均有显著性(P<0.05)。结论：术后低蛋白血症是食管癌、贲门癌根治术预后的重要影响因素。临床上除了加强围手术期治疗、护理以外，更应该关注患者围术期的营养状况。对存在营养风险的患者，及时采取有效的干预措施，积极预防和纠正低蛋白血症，对降低术后并发症的发生、缩短住院及监护时间、改善患者的预后状况具有重要的临床意义。
【关键词】低蛋白血症；食管癌、贲门癌；预后；血清白蛋白
Effect of Hypoproteinemia on prognosis of esophageal cancerand cardia cancer
SUN Chao， SHAO Xue-zhai， ZHOU Lu-qi， XU Xin-hua，JI Ying
(The Affi lianted Hospital of Chengde Medical College，Chengde 067000， China)
【Abstract】 Objective： To investigate the infl uence of hypoproteinemia on prognosis of patients undergoing Radical Resection of gastric cardiac carcinoma or Esophageal Cancer. Methods： the clinical data of 174 cases of patients undergoing Radical Resection of gastric cardiac carcinoma or Esophageal Cancer were retrospectively analyzed from January 2009 to June 2012. To investigate whether there is difference between post operation hospitalization duration， monitoring time， second operation needed or not， prognosis， and complications， the patients with normal albumin (ALB ≥ 35g / L) and low albumin (ALB <35g / L) were observed before and after the operation ，so the patients were divided into 4 groups (preoperative， postoperative normal albumin group， and preoperative， postoperative low serum albumin group). Results： preoperative albumin group and normal albumin group show no signifi cant differences (P > 0.05). However， there were obvious differences between postoperative low albumin group and normal albumin group， in the postoperative hospitalization duration， monitoring time， the prognosis， the incidence of the secondary surgery， incision infection， anastomotic fi stula and other complications(P < 0.05). Conclusion： postoperative hypoproteinemia is the critical factors infl uencing the prognosis of radical resection of carcinoma of esophagus and cardiac cancer. During the perioperation period， in addition to improve the clinical treatment and nursing care， more attention should be paid on the nutritional status of the patients. For the patients with malnutrition，it is a wise decision to taken timely and effectively intervention measures to prevent the occurrence of hypoproteinemia ，which may reduce both the hospitalization and care time and the incidence of postoperative complications. (尹艳艳)
【关键词】低蛋白血症；食管癌、贲门癌；预后；血清白蛋白
Effect of Hypoproteinemia on prognosis of esophageal cancerand cardia cancer
SUN Chao， SHAO Xue-zhai， ZHOU Lu-qi， XU Xin-hua，JI Ying
(The Affi lianted Hospital of Chengde Medical College，Chengde 067000， China)
【Abstract】 Objective： To investigate the infl uence of hypoproteinemia on prognosis of patients undergoing Radical Resection of gastric cardiac carcinoma or Esophageal Cancer. Methods： the clinical data of 174 cases of patients undergoing Radical Resection of gastric cardiac carcinoma or Esophageal Cancer were retrospectively analyzed from January 2009 to June 2012. To investigate whether there is difference between post operation hospitalization duration， monitoring time， second operation needed or not， prognosis， and complications， the patients with normal albumin (ALB ≥ 35g / L) and low albumin (ALB <35g / L) were observed before and after the operation ，so the patients were divided into 4 groups (preoperative， postoperative normal albumin group， and preoperative， postoperative low serum albumin group). Results： preoperative albumin group and normal albumin group show no signifi cant differences (P > 0.05). However， there were obvious differences between postoperative low albumin group and normal albumin group， in the postoperative hospitalization duration， monitoring time， the prognosis， the incidence of the secondary surgery， incision infection， anastomotic fi stula and other complications(P < 0.05). Conclusion： postoperative hypoproteinemia is the critical factors infl uencing the prognosis of radical resection of carcinoma of esophagus and cardiac cancer. During the perioperation period， in addition to improve the clinical treatment and nursing care， more attention should be paid on the nutritional status of the patients. For the patients with malnutrition，it is a wise decision to taken timely and effectively intervention measures to prevent the occurrence of hypoproteinemia ，which may reduce both the hospitalization and care time and the incidence of postoperative complications. (尹艳艳)