肝癌患者术后血浆与白蛋白联合输注的临床观察

The Clinical Observation of Albumin and Plasma Combining Transfusion for Patients with Hepatocelluar Carcinoma

目的探讨肝癌患者单纯输注白蛋白和联合输注白蛋白＋新鲜冰冻血浆的临床疗效。方法68例肝癌患者随机份白蛋白组（34例）联合输注白蛋白＋新鲜冰冻血浆组（34例）。排除门脉栓患者术后易出现肝功异常，大量腹水的出现，蛋白降低（〈30g／L）。联合组每天输注蛋白10g／L和新鲜冰冻血浆200ml，直到蛋白〉31g/L，腹水减少，食欲增加，大约需5～7d。蛋白组每天输注蛋白10～20g／L，约5～7d。结果两组有显著差异（P〈0．05），蛋白组提高蛋白有效率达90．8％，但肝功能（ALT）恢复较慢，大量腹水无变化。联合组提高蛋白有效率达96．78％，腹水明显减少，食欲增加，ALT指数降低，肝功能恢复较快。结论肝癌患者术后采用白蛋白和血浆联合输注，较快的提高了蛋白，有利益于肝功能的恢复，腹水明显减少，食欲增加，易于患者术后的恢复。

Objective To explore the clinical effects of albumin transfusion （ Group 1 ） and albumin combined with plasma（ Group 2） transfusion for hepatocelluar carcinoma. Methods 2 groups were designed and each group had 34 cases of patients who after the operation to dislodge thrombus in portal vein and had some symtoms such as liver dysfuntion, ascite or decreased blood albumin（ 〈 30 g/L）. Group 1 were infused albumin at the dosage of 10 -20 g/d for 5-7 days,while Group 2 were insfused albumin for 10-20 g/d and freshly frozened plasma 200 mL/d for 5-7 days. Results There was significant difference between Group 1 and Group 2. In Group 1 ,blood albumin were effetively increased（ 〉 30 g/L）by 90. 8% , while ALT recovered slowly and there were no obvious changes for ascite. In group 2 ,the effective ratio for raising albumin was 96. 78% ,ascite was reduced obviously, the count of of ALT and liver function recovered more quickly than Group 1 while provoking the appetite. Conclusion The combined transfusion of albumin and plasma may raise blood albumin effectively and be advantageous to liver functional recovery, reducing ascite and provoking the appetite. This treatment is favorable to support recovery after surgical operation.