我院肝移植围术期人血白蛋白管控方案临床实践与评价

Establishment and Evaluation of Human Albumin Administration During the Perioperative Period of Liver Transplantation in Our Hospital

目的建立和评价肝移植围手术期人血白蛋白给药方案,促进人血白蛋白的合理使用。方法人血白蛋白给药新方案于2020年8月建立。对2020.02~2021.01期间91例肝移植患者进行回顾性筛查。将患者分为对照组(n=41)和干预组(n=50)。收集分析两组患者的基本资料、肝功能、血清白蛋白浓度、术后白蛋白用量、术后并发症及住院费用等。结果两组围手术期基本资料、出入院肝功能各项指标及术前、术后3d、出院前血清白蛋白浓度,除入院时直接胆红素和间接胆红素水平差异具有统计学意义(P<0.05),其他各项指标差异均无统计学意义(P>0.05)。干预组术后白蛋白总量、白蛋白费用/住院费用明显低于对照组(P<0.05),而人均住院费用差异无统计学意义(P>0.05)。术后并发症无明显变化(P>0.05)。结论人血白蛋白给药方案减少了肝移植术后的人血白蛋白用量,减轻患者经济负担,且对患者预后无明显影响,促进了人血白蛋白的合理使用。

OBJECTIVE To establish and evaluate the administration regimen of human albumin during the perioperative of liver transplantation and to promote the rational use of human albumin.METHODS The new administration regimen of human albumin was established in 2020.08.A total of 91 cases of liver transplantation during the period of 2020.02 and 2021.02 were retrospectively screened.The patients were divided into control group(n=41)and intervention group(n=50).The basic data of patients in the two groups,liver function,serum albumin index,usage of albumin dosage,related complications and hospitalization expenses were collected and analyzed.RESULTS There were significant differences in perioperative basic data,indexes of liver function at admission,serum albumin concentration before operation,3 days after operation and before discharge between the two groups,except for direct bilirubin and indirect bilirubin at admission(P<0.05).There was no significant difference in other indexes(P>0.05).The total albumin and albumin cost/hospitalization cost in the intervention group were significantly lower than those in the control group(P<0.05).There was no significant change in postoperative complications(P>0.05).CONCLUSION The albumin administration regimen did reduce the amount of albumin in the perioperative period of liver transplantation,reduce the financial burden of patients,and had no significantly changes on the prognosis of patients,and promote the rational use of human serum albumin.