Study Of Variations Of And Correlations Between Plasma Albumin And Inflammatory Medium In The Early Stage After Different Abdominal Surgery

Objective:Discuss whether the content level of plasma albumin will drop in the early stage after operations on different parts of abdomen and whether such reduction is related to the level of inflammatory medium through testing the content of plasma albumin as well as the concentration of serum inflammatory medium in the early stage after operations on different parts of abdomen.Methods:Select 45 patients hospitalized in the surgical ward of the Second Affiliated Hospital of Kunming Medicine University from August of 2008 to March of 2009,among whom 15 are of cholecystolithiasis,15 of cholecystolithiasis and choledocholithiasis,15 of alimentary canal cancer(5 of rectum carcinoma,4 of stomach cancer,6 of colon cancer).Cholecystolithiasis patients have been done cholecystectomy;cholecystolithiasis and choledocholithiasis patientshave been done cholecystectomy exploration of the common bile duc;digestive tract cancer patients have been done tumorradical correction;All patients have been applied general anesthesia.These patients are divided into three groups according to different types of operations applied,which are the cystectomy group,the cystectomy + biliary detection group and the alimentary canal tumor cure group.12h,24h,48h,72h before and after operation,all three groups have been tested on plasma albumin concentration, plasma capacity,semmIL-6 and TNF-αconcentration.The content of plasma albumin of every patient is calculated based on the testing results.Results:1.Variations of the content of plasma albumin:①Comparison within the same group:the comparison of the content of plasma albumin before and after operation of the cystectomy group has no statistical value(P>0.05);the comparison of the content of plasma albumin 12h,24h,48h,72h before and after operation shows reduction in the level in the cystectomy + biliary detection group and the decanal tumor cure group(P<0.01).②Comparison between the groups:the comparison of the content of plasma albumin before operation of the three groups has no statistical value (P>0.05);12h,24h,48h,72h after operation,the cystectomy + biliary detection group and the digestive tract tumor cure group show obvious alterations in the content of plasma albumin compared with the cystectomy group(P<0.01);24h,48h,72h after operation,the content of plasma albumin of the alimentary canal tumor cure group differs greatly from that of the cystectomy + biliary detection group(P<0.01);③In both the cystectomy + biliary detection group and the alimentary canal tumor cure group,the level of the content of plasma albumin drops to the lowest 48h after operation,with a more outstanding decrease in the digestive tract tumor cure group.2.Variations of the concentration of serum inflammatory medium:①Variations of the concentration of serum IL-6:1 ) Comparison within the same group:Compared with pre-operation results,the cystectomy group reflects great difference 12h,24h, 48h after operation(P<0.01),and no obvious difference 72h after operation(P> 0.05);However,by comparing the results 12h,24h,48h,72h before and after operation,both the cystectomy + biliary detection group and the alimentary canal tumor cure group display extraordinary discrepancy(P<0.01 ).2 )Comparison between the groups:Before operation,there is no clear divergence between the three groups (P>0.05).12h,24h,48h,72h after the operation,all three groups show great difference in their testing results of the concentration of serum IL-6(P<0.01 ).②Variations of the concentration of serum TNF-α:1 ) Comparison within the same group:In the cystectomy group,the testing results of 12h,24h,48h after operation show obvious difference compared with those before operation(P<0.01),the comparison 72h before and after operation has no statistical value(P>0.05);The comparison 12h,24h,48h,72h before and after operation reflects magnificent divergence in the cystectomy + biliary detection group and the digestive tract tumor cure group(P<0.01).2) Comparison between the groups:The comparison of the TNF-αbefore operation between the groups shows no obvious difference(P > 0.05 ); 12h,24h,48h,72h after the operation,all three groups show great difference in their testing results of the concentration of serum TNF-α(P<0.01 ).3.The content of plasma albumin shows a negative correlation with the concentration oftheIL-6 and TNF- a;(r=-0.376,P=0.000;r=-0.772,P=0.000).Conclusion 1.The cystectomy group has no difference in the content of albumin after operation,while the cystectomy + biliary detection group and the alimentary canal tumor cure group show reduction in the content of plasma albumin,with the most obvious decrease 48h after operation.The alimentary canal tumor cure group reflects a more clear reduction in the content of albumin after operation.2.The content of plasma albumin shows a negative correlation with the concentration of inflammatory medium in the early stage after operations on different parts of abdomen.