The Change Trend And Affecting Factors Of Plasma Protein In Severely Burn Patients

BackgroundIn our blood plasma, albumin is the most abundant protein. It has many physiological functions.For example,it can combine and transport many substances; maintain blood colloid osmotic pressure;remove free radicals;provide nutrition for the body;inhibit platelet aggregation. There are several factors that colud cause hypoalbuminemia such as operation, burns,infection,etc. The loss of albumin, the internal and external redistribution of albumin are the most common reasons. Because of its physiological functions, it plays an important role in the prognosis of the patients.During recent decades, we found that almost every burn patient has different degrees of low protein in our clinical treatment course. However,there is no cases analysis report to prove the explicit reason for hypoalbuminemia in serve burns patients.So we conducted this research to identify the factors which can induce hypoalbuminemia.Objective:Through the analysis of albumin’s falling trend at the different stages of burned patients (shock stage, the first cutting scab, sepsis),to explore whether the degree of burned, the process of treatment,some intervention measures, and correlation of contact can influence the plasma albumin.Make sure whether there is relationship between serum albumin level and prognosis and complications.MethodsPart Ⅰ Research of tendency of albumin after servere burns and analysis of its reasonsWe collect 112 severe burned cases with complete data at TaiShan Medical College from 2007 to 2015. We record their process of treatment and the values of serum albumin at the 1st,3rd,7th,14th,21th day,then to statistics and analyze:l.to clear whether there is correlation between serum albumin degree in patients and burned area and the three degrees of burned area.2. According to whether the patients had early cutting scab surgery, divided the patients into 2 groups. Contrast the changes of serum albumin level before and after operation in the two groups.Make sure whether the surgery influence the level of serum albumin in patients.3. According to whether use recombinant human growth hormone at the process,the patients were divided into 2 groups, Clear the influence of growth hormone to the serum albumin of patients.Part Ⅱ How the lower levels of albumin impact on the prognosis of patients and the complications of infection.The 112 patients had different degree of infections on thire treatment process.,For example,wound infection, infection of the lungs, abdominal cavity infection, septicemia, etc. According to the patient’s prognosis and whether there is sepsis, group the 112 patients, then analyze the albumin levels of two groups of patients,to clear whether there is relationship between albumin levels and prognosis, sepsis in patients.Results:The 112 cases of burn patients appeared different degree hypoalbuminemia.On the day of admission open enteral nutrition (EN), and complement intravenous nutrition (PN) in different degrees.① The degree of protein decreased,the burned area and third-degree burned area were positively correlated.②The patients with surgery,their albumin decreased average (8.83±1.08) g/L,albumin in patients with non surgery group decreased average (13.9±1.15 g/L). The variable t test, indicate that early surgery can inhibit the extent of albumin.③Growth hormone treatment group, the average minimum value of albumin (25.77±2.97) g/L, the control group, the average minimum value of albumin (22.77±2.08) g/L. The two group t test, the results showed that the application of growth hormone can reduce the degree of decrease of albumin.According to the patient of the research,the study found that,± After 4-5days,In the cure group, the mean serum albumin remained above 25g/L, while the death group was significantly decreased (P<0.05), which showed that the plasma albumin level had a certain relationship with the prognosis.②Comparing sepsis and non sepsis group, the two groups at 6th-9th day (26.3±3.9 g/L and 27.9±4.7 g/L, respectively), 10-14 days (respectively 28.2±4.5 g/L,29.6±5.2 g/L),there is a significant difference in protein.There is a certain relationship between the occurrence of severe and albumin levels.Conclusion1. Severe burned patients combined with low serum albumin extensively and long term.2.The severity of burn injury was positively correlated with the decrease of serum albumin. The more severe burned, the greater the area of burn, the more obvious the albumin decreased.3. Early surgical excision can directly affect the level of albumin in patients.4. Growth hormone can reduce the falling degree of albumin,and promote the synthesis of albumin.5. To a certain extent,albumin level can predict the prognosis of the patients,,and it correlate with the occurrence of sepsis.In this paper,112 cases of severe burn patients were collected, the treatment and the serum albumin level were recorded, and the multiple statistical analysis was performed. Through statistics of burn patients albumin decreased trend, to investigate the influence of the degree of burn, treatment and intervention measures to plasma albumin in patients, and the relationship between albumin level reduced and the prognosis of patients and the complications.