高、低浓度人血白蛋白在原发性肝癌患者半肝切除术后的应用比较

High concentration of human serum albumin versus low concentration of human serum albumin in patients with primary hepatocellular carcinoma after hemihepatectomy

目的比较高浓度人血白蛋白(25%)与低浓度人血白蛋白(5%)治疗原发性肝癌患者半肝切除术后的疗效和安全性。方法 93例原发性肝癌行半肝切除术后分别应用高、低浓度人血白蛋白进行治疗,比较2组肝肾功能、凝血功能、电解质、胸腹水量、尿量等指标的变化情况及术后恢复。结果与使用5%人血白蛋白患者比较,术后使用25%人血白蛋白患者的白蛋白、前白蛋白值显著较高(P <0. 05),平均每日尿量、术后每日腹水引流量显著较低(P <0. 05),而白细胞计数、中性粒细胞、谷丙转氨酶、总胆红素、凝血酶原时间比较无显著差异(P>0. 05)。结论高浓度人血白蛋白比低浓度人血白蛋白更适用于原发性肝癌行半肝切除术后低蛋白血症并腹水的患者。

Objective To compare the efficiency and safety of high concentrations of human serum albumin （25%） and low concentration of human serum albumin （5%） in the treatment of patients with primary hepatocellular carcinoma after hemihepatectomy. Methods A total of 93 patients with primary hepatocellular carcinoma were treated with high concentrations of human serum albumin or low concentration of human serum albumin after hemihepatectomy. Liver and kidney functions, blood coagulation function, electrolyte, hydrothorax and ascites, urine output and other indicators as well as postoperative recovery were compared between two groups. Results Compared with patients treated by 5% human serum albumin, patients with 25% human serum albumin had higher levels of albumin and prealbumin （ P 〈0.05）, and lower average daily urine output and postoperative daily ascites drainage （ P 〈0.05）, but there were no significant differences in white blood cell count, neutrophil, alanine aminotransferase, total bilirubin and prothrombin time between two groups （ P 〉0.05）. Conclution Compared to low concentration of human serum albumin, high concentration of human serum albumin is more suitable for patients with hypoproteinemia and ascites after hemihepatectomy for primary liver cancer.