HES能改善消化道肿瘤术后早期血浆白蛋白及炎性介质水平

Hydroxyethyl Starch could Improve the Level of Plasma Albumin and Inflammatory Mediators in Patients with Gastrointestinal Neoplasms after Radical Mastectomy

为探讨羟乙基淀粉（HES）在消化道肿瘤根治术后的使用过程中，对早期血浆白蛋白及炎性介质变化的影响，本研究选取90例我院自2013年8月至2016年12月收治的接受消化道肿瘤根治术患者，将患者随机分为对照组（n=45）和观察组（n=45）。术后对照组即刻输注等渗盐水，观察组术后即刻输注等量羟乙基淀粉注射液，连续输注7d。术后第7天采用免疫比浊法检测两组术后早期血浆白蛋白水平；采用酶联免疫吸附试验检测两组治疗前、后的炎性介质水平（C-反应蛋白，IL-6，TNF-α），并比较两组临床疗效及对术后早期血浆白蛋白、炎性介质变化的影响。结果显示，观察组与对照组术后血浆白蛋白水平均呈“先抑后扬”的水平曲线。但是，观察组术后第l天、第3天、第5天及第7天的早期血浆白蛋白水平显著提升，明显高于对照组（p〈0.05）；观察组术后第7天炎性介质的血清水平明显低于对照组（p〈0．05）；在并发症发生率方面，两组并发症发生概率分别为6．67％和8．89％，其差异无统计学意义（p〉0．05）。根据研究结果可以推断，将输注HSE用于消化道肿瘤根治术，能够显著提高血浆白蛋白，降低炎性介质水平，从而加快患者的身体机能恢复，提高手术预后，效果理想。

In order to investigate the effect ofhydroxyethyl starch on plasma albumin and inflammatory mediators after radical resection of digestive tract, 90 patients with radical resection of gastrointestinal cancer from August 2013 to December 2016 were chosen and randomly divided into control group （n=45） and observation group （n=45）. In the control group, the same amount of isotonic saline was infused immediately after the operation. The hydroxyethyl starch was infused immediately after the operation for 7 days. The plasma albumin level was detected by immunoturbidimetry. The levels of C-reactive protein, interleukin-6 and tumor necrosis factor-oL were measured before and after treatment. The effects of two groups on the clinical efficacy and plasma albumin and inflammatory mediators were compared. The results shown that the levels of plasma albumin in the two groups decreased at first and then increased. However, the plasma albumin levels of 1 d, 3 d, 5 d and 7 d after operation in the observation group, which were significantly higher than those in the control group （p 〈0.05）. The level of inflammatory mediators in the observation group 7 days after operation was significantly lower than that in the control group （p〈0.05）. In terms of incidence of complications, the probability of occurrence of complications in the two groups was 6.67% and 8.89% respectively, and there was no significant difference between two groups （p〉0.05）. According to the results of the study, the effect ofhydroxyethyl starch infusion is ideal, it could improve the level of plasma albumin and inflammatory mediators, accelerate the recovery of the physical function of the patient and improve the prognosis of operation in early time after operation.