摘要 目的:探讨急性肠套叠患儿术后血浆白蛋白浓度的变化及意义。方法:用全自动生化分析仪分别测定32例轻症、21例重症急性肠套叠患儿术后第1天和治疗干预后术后第5天血浆白蛋白浓度及30例正常对照儿童血浆白蛋白浓度,并将轻重肠套叠两组患儿术后第1天的血浆白蛋白浓度与小儿危重评分进行相关性分析。结果:与正常对照组比较,轻症组与重症组血浆白蛋白浓度均下降,轻症组:(34.2±6.5)g/L vs (37.1±4.1)g/L,差异有显著性(P<0.05);重症组:(25.8±7.5)g/L vs (37.1±4.1)g/L, P<0.01;重症组血浆白蛋白浓度明显低于轻症组,差异有显著性(P<0.05)。术后第5天,轻症组白蛋白浓度为(37.1±11.4)g/L高于术后第1天,差异有显著性(P<0.05);重症组血浆白蛋白浓度术后第5天与术后第1天比较,差异无显著性(t=1.675,P>0.05)。术后第1天血浆白蛋白浓度与小儿危重评分之间成正相关(r=0.879, P<0.01)。结论:急性肠套叠患儿术后第1天血浆白蛋白有不同程度的降低,并与急性肠套叠患儿术后严重程度相关;重症病例低白蛋白血症持续时间长,并与治疗干预无关。血浆白蛋白浓度测定可作为急性肠套叠患儿术后严重程度的预警指标。[中国当代儿科杂志,2009,11(4):277-279]
Abstract:OBJECTIVE: To study the changes of serum albumin contents after operation and investigate whether post-operational serum albumin contents are correlated with the disease severity in children with acute intussusception. METHODS: Serum albumin contents were measured using the automatic biochemistry analyzer in 32 children with mild acute intussusception and 21 children with severe acute intussusception 1 day after surgical operation. After 5 days combined treatment, serum albumin contents were re-examined. Thirty healthy children severed as the control group. The correlation between post-operational serum albumin contents and critical illness scores was evaluated. RESULTS: Serum albumin contents in the mild (34.2±6.5 g/L; P<0.05) and the severe intussusception groups (25.8±7.5 g/L;P<0.01) 1 day after operation were significantly lower than those in the control group (37.1±4.1 g/L). There were significant differences in serum albumin contents between the mild and the severe intussusception groups (P<0.05). Five days after operation, serum albumin contents in the mild intussusception group significantly increased (37.1±11.4 g/L; P<0.05), while serum albumin contents in the severe intussusception group did not differ from those 1 day after operation. There was a positive correlation between serum albumin contents on the 1st day after operation and the critical illness scores (r=0.879, P<0.01). CONCLUSIONS: Serum albumin contents decreased on the 1st day after operation and were correlated with the disease severity in children with acute intussusception. Hypoalbuminemia lasted for a longer period in severe cases. The post-operational measurement of serum albumin contents may be useful in the evaluation of the severity for children with acute intussusception.[Chin J Contemp Pediatr, 2009, 11 (4):277-279]
XIA Chan,HAN Guo-Qiang,YE Jing et al. Contents of serum albumin after surgical operation in children with acute intussusception[J]. CJCP, 2009, 11(04): 277-279.
[2]Nedrebo T, Reed RK. Different serotypes of endotoxin (lipopolysaccharide) cause different increases in albumin extravasation in rats[J]. Shock, 2002,18(2):138-141.
[12]Spiess A, Mikalunas V, Carlson S, Zimmer M, Craig RM. Albumin kinetics in hypoalbuminemic patients receiving total parentral nutrition[J].JPEN J Parenter Enteral Nutr, 1996, 20(6):424-428.