Effects Of Trentment With Hydroxyethyl Starch 130/0.4 On The Serum Albumin And Immunologic Function In Postoperative Patients With Obstructive Jaundice

Objective:To investigate the effects of trentment with hydroxyethyl starch 130/ 0.4 on the serum albumin and immunologic function in postoperative patients with obstructive jaundice.Methods:24 patients with obstructive jaundice hospitalized in the VIP general surgery department of the second affiliated hospital of Kunming medical college from 2007.6 to 2008.3 were randomly divided into the control group(n=12)and HES group(n=12).10ml.kg^-1.d^-1hydroxyethyl starch 130/0.4 was infused in HES group including 6 males and 6 females;The control group including 4 males and 8 females accept the same transfusion project and the hydroxyethyl starch 130/0.4 section was replaced by the same volume normal saline;.The blood serum hepatic function index(ALT,AST,CHE,ALB,PA),lymphocyte(LYM)and immunologic index(IgG,IgA,IgM,C3,C4 and T cell subset)were monitored respectively before operation, and plasma volume of patients were measured with Hydroxyethyl Starch.The operation time was recorded at the end of operation;Then the ALB concentration and plasma volume were detected 1d,3d,5d,7d after the operation,The ALB content was calculated on the basis of:ALB content=ALB concentration×PV(plasma volume)and IgG,IgA,IgM,LYM,C3,C4 and T cell subset were detected again 1d and 7d after the operation.All statistical analysis was done with SPSS 11.5 software.Results:1.The two group were comparable with age,body weight,operation time,preoperative hepatic function index,preoperative immunologic index and so on(P＞0.05).2.The ALB content of control group had no significant differences in the preoperative and postoperative 1d,7d VS HES group(P＞0.05)and the ALB content of HES group was higher in the postoperative 3d,5d VS control group(P＜0.05);The ALB content of control group and HES group had significant differences in the postoperative 1d,3d,5d,7d VS preoperative(P＜0.05).3.All immunologic index and the index difference(postoperative7d-1d)of HES group had no significant differences in the preoperative and postoperative 1d,7d VS control group(P＞0.05);IgG,C3,CD3⁺ T of both groups and IgM of control group were lower in the postoperative 1d,7d VS preoperative(P＜0.05or 0.01);LYM,C4,CD4⁺ T,CD4⁺/CD8⁺ of both groups were lower in the postoperative 1d VS preoperative(P＜0.05or 0.01) and had no significant differences in the postoperative 7d VS preoperative(P＞0.05); IgA of both groups and IgM of HES group had no significant differences in the postoperative ld VS preoperative(P＞0.05)and they were lower in the postoperative 7d VS preoperative(P＜0.01);CD8⁺ T of both groups had no significant differences in the postoperativeld,7d VS preoperative(P＞0.05).Conclusion:1.The ALB content of patients would reduce postoperative with obstructive jaundice and sharply in the postoperative 3d,considering that partly relevant to capillary leak;Trentment with hydroxyethyl starch 130/0.4 could alleviate the drop of the ALB content;2.Immunologic function of patients become poorer postoperative and trentment with hydroxyethyl starch 130/0.4 in the postoperative had no apparent effects on immunologic function of patients with obstructive jaundice.