Dissertation
Dissertation > Medicine, health > Surgery > Of surgery > Abdominal surgery

Study of Variations of and Correlations between Plasma Albumin and Inflammatory Medium in the early Stage after Different Abdominal Surgery

Author LiShuMin
Tutor XuPengYuan;ZuoYunYun;ChenXiongZhi;LiuJian
School Kunming Medical College
Course Surgery
Keywords Abdominal surgery Plasma albumin Tumor necrosis factor α Interleukin- 6
CLC R656
Type Master's thesis
Year 2009
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Objective: To detect different after abdominal surgery early plasma albumin content and serum inflammatory mediators concentration of abdominal surgery early after the existence of plasma albumin content decreased and early postoperative plasma albumin content is related to the levels of inflammatory mediators. Methods: 15 cases admitted to the hospital from August 2008 to March 2009, the Second Affiliated Hospital of Kunming Medical dry treatment surgical elective abdominal surgery, 45 patients, including 15 cases of patients with gallstones, gallstones and choledocholithiasis patients gastrointestinal cancer patients (15 cases, five cases of rectal cancer, stomach cancer, colon cancer, 6 cases). Gallstone patients underwent open cholecystectomy; gallstones and common bile duct stones in patients underwent open cholecystectomy, common bile duct, T tube drainage and peritoneal drainage; gastrointestinal cancer patients underwent open radical tumor surgery ; all patients are selected anesthesia. The surgical patients were divided into the cholecystectomy group cholecystectomy bile duct exploration group, gastrointestinal cancer radical group. Three groups of patients in the preoperative and postoperative 12h, 24h, 48h, 72h determination of plasma albumin concentration, plasma volume, serum IL-6, TNF-α concentration; plasma volume and plasma albumin concentration, calculated for each patient plasma albumin content. Results: 1. Serum albumin content: ① group albumin content than: cholecystectomy group of patients albumin content preoperative not statistically significant (P> 0.05); after 12h, 24h, 48h and 72h cholecystectomy bile duct exploration group, gastrointestinal tumors radical group of patients with plasma albumin content preoperative comparison were lower (P <0.01). Albumin content ② group: surgery the first three groups of patients with albumin levels was not statistically significant (P> 0.05); after 12h, 24h, 48h and 72h gastrointestinal tumors radical group, cholecystectomy biliary exploration group plasma white The protein content than the gallbladder resection group, there was a significant difference (P <0.01); after 24h, 48h and 72h gastrointestinal tumor cure plasma albumin content than cholecystectomy bile duct exploration group there was a significant difference (P <0.01); ③ The cholecystectomy bile duct exploration group and gastrointestinal tumors radical group 48h after plasma albumin content to meet the minimum, gastrointestinal cancer radical group decreased serum albumin is more obvious. Concentration of serum inflammatory mediators: ① serum IL-6 concentration changes: 1) group within the IL-6 concentration ratio: the cholecystectomy group of patients 12h, 24h, 48h and preoperative than to have very significant differences (P <0.01 ), the the cholecystectomy group of patients 72h after preoperative than no significant difference (P> 0.05); cholecystectomy bile duct exploration group, gastrointestinal tumor radical group of patients 12h, 24h, 48h, 72h, and preoperative ratios are very significant differences (P <0.01). 2) IL-6 comparison: the the surgery first three group IL-6 was no significant difference (P> 0.05). After 12h, 24h, 48h, 72h cholecystectomy group with gallbladder removal of the bile duct exploration group, gastrointestinal cancer radical group, there was a significant difference (P <0.01). After 12h, 24h, 48h, 72h, cholecystectomy bile duct exploration group elimination and gastrointestinal tumors radical group has a very significant difference (P <0.01). (2) changes in the concentration of serum TNF-α: 1) group within the TNF-α concentrations: the cholecystectomy group of patients 12h, 24h, 48h compared with preoperative there are very significant differences (P <0.01), 72h after surgery compared with was not statistically significant (P> 0.05); cholecystectomy bile duct exploration group, digestive tract tumor radical group after 12h, 24h, 48h, 72h compared with preoperative there was a significant difference (P <0.01). 2) group between the TNF-α concentrations to: surgery first three sets of IL-6 was no significant difference (P> 0.05); postoperative 12h, 24h, 48h, 72h gallbladder removal of bile duct exploration group, gastrointestinal tumors radical group cholecystectomy group there was a significant difference (P <0.01), postoperative 12h, 24h, 48h, 72h cholecystectomy bile duct exploration group has a very significant difference (P <0.01) and gastrointestinal tumors radical group. Plasma albumin content of IL-6, TNF-a concentrations were negatively correlated; (r = -0.376, P = 0.000; r = -0.772, P = 0.000). Conclusions the cholecystectomy group of patients albumin content without reducing cholecystectomy bile duct exploration group, gastrointestinal tumor radical group patients reduced plasma albumin content after 48h of which the most obvious digestive tract cancer cure postoperative albumin decreased more obvious. 2. Abdomen early postoperative albumin levels and inflammatory mediators concentrations were negatively correlated.

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