羟乙基淀粉对患者血浆ALB、炎症因子及肺功能的影响

Effect of Hydroxyethyl Starch on Plasma ALB, Inflammatory Factors and Lung Function in Patients with Digestive Tract Cancer

探讨消化道肿瘤根治术后采用羟乙基淀粉治疗对患者血浆白蛋白（ALB）、炎症因子、肺功能的影响。选取在我院（2014年4月至2016年12月）实施根治性手术的120例消化道肿瘤患者,其中60例患者术后输入羟乙基淀粉10 m L/kg/d（实验组）、另外60例患者术后输入平衡液（对照组）,两组患者其余基础治疗措施保持一致,对比两种两组患者术后不同时间点的血浆ALB、炎症因子及肺通气及换气功能。结果显示：术前,实验组和对照组的血浆ALB、血清IL-6、TNF-α、CRP、肾素、血管紧张素Ⅱ、醛固酮、尿量水平比较,差异均无统计学意义（p〉0.05）;术后24 h、术后48 h、术后72 h,实验组的血浆白蛋白显著的高于对照组（p〈0.05）,血清IL-6、TNF-α、CRP、血管紧张素Ⅱ水平显著的低于对照组（p〈0.05）;术后24 h、术后48 h,实验组患者的尿量显著的高于对照组（p〈0.05）;术前,实验组和对照组的FVC、FEV1、MVV、PaO_2/FiO_2比较,差异均无统计学意义（p〉0.05）;术后72 h,实验组的FVC、FEV1、MVV、PaO_2/FiO_2显著的高于对照组（p〈0.05）。结果表明：消化道肿瘤根治术后采用羟乙基淀粉治疗有利于维持患者血浆ALB、减轻炎症反应、维持液体平衡,减轻肺损伤。

This study was to investigate the effect of hydroxyethyl starch on serum albumin（ALB）, inflammatory factors and lung function in patients with digestive tract cancer after radical gastrectomy. This study selected 120 cases of patients with digestive tract cancer after radical surgery in our hospital（2014.4~2016.12）, including 60 cases of patients treatd with hydroxyethyl starch 10 mL/kg/d after surgery（experimental group）, and another 60 cases of patients treated with balanced fluid after surgery（control group）. Their foundational treatment measures were consistent. Then the plasma ALB, inflammatory factors, pulmonary ventilation and ventilation function of two groups at different times were compared. The results showed that before surgery, plasma ALB, serum IL-6,TNF-alpha, CRP, renin, angiotensin, aldosterone and urine volume level in the experimental group and the control group had no significant differences（P〈0.05）. At 24 h, 48 h, 72 h after operation, the plasma albumin in the experimental group was significantly higher than the control group（P〈0.05）, and the levels of serum IL-6,TNF-alpha, CRP, angiotensin II were significantly lower than those of control group（P〈0.05）. In the postoperative24 h, 48 h, the urine volume in experimental group were significantly higher than the control group（P〈0.05）.Before operation, comparing the experimental group and control group in FVC, FEV1 MVV and PaO_2/FiO_2, there were no significant differences（P〈0.05）. At 72 h after the operation, FVC, FEV1, MVV and PaO_2/FiO_2 of the experimental group were significantly higher than those of control group（P〈0.05）. The results showed that after the radical resection of digestive tract tumor, hydroxyethyl starch treatment might be beneficial to maintain the plasma ALB, relieve the inflammatory reaction, maintain the balance of fluid and relieve lung injury.