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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。
Objective: To investigate the effect of perioperative hypoproteinemia on the prognosis of esophageal cancer and cardiac cancer. Methods: A retrospective analysis of January 2009 to June 2012 in esophageal cancer, cardia cancer radical surgery of 174 patients with case data. Serum albumin (ALB) was used as the standard of grouping to observe the changes of hospitalization time, monitoring time, blood pressure, blood pressure and serum albumin in preoperative and postoperative normal albumin (ALB≥35g / L) and low albumin (ALB≤35g / Secondary surgery, adverse prognosis and complications occurred whether there are differences. Results: Compared with normal albumin group, there was no significant difference in preoperative low albumin group and normal albumin group (P> 0.05), while postoperative low albumin group and normal albumin group showed no significant difference in postoperative hospital stay , Monitoring time, adverse prognosis, secondary surgery or in the complications of lung complications, incision infection, anastomotic leakage and other complications were significant differences (P <0.05). Conclusion: Postoperative hypoproteinemia is an important factor affecting the prognosis of esophageal cancer and gastric cardia cancer. In addition to strengthening the clinical perioperative treatment, nursing, patients should pay more attention to nutritional status during the perioperative period. For patients with nutritional risk, timely and effective interventions, and actively prevent and correct hypoproteinemia, reduce the incidence of postoperative complications, reduce hospitalization and monitoring time, improve the prognosis of patients with important clinical significance.