Clinical Study On The Effect Of Albumin On Short-term Prognosis Of Patients Undergoing Valve Replacement Surgery Under Extracorporeal Circulation

Objective: To investigate the efficacy and safety of albumin priming solution for ECC in adult patients undergoing heart valve replacement surgery,improve the prognosis of patients and improve the quality of treatment.Methods: 120 patients who were diagnosed as valvular heart disease and underwent valve replacement surgery under ECC and were sent to ICU for observation and treatment after surgery were selected and divided into two groups,each with 60 patients.The patients in the control group were treated with common crystal pre-filling liquid or mixed pre-filling liquid of crystal artificial colloid,while the patients in the observation group were treated with albumin pre-filling liquid.The duration of intubation,the VTE score of the two groups of patients,the length of stay in ICU,whether delirium occurred,24 hours before and after operation,48 hours after operation,and 72 hours after operation,cardiac injury markers troponin,inflammatory factors(serum amyloprotein A,C-reactive protein,IL-6,WBC),BUN,Cr,etc.were analyzed.Results:(1)There was no statistically significant difference in troponin levels between the observation group and the control group.(2)Inflammatory factors: Serum amyloid A,C-reactive protein,IL-6,and white blood cells may increase after surgery,but at 72 hours after surgery,the level of IL-6 in the observation group will be lower than that in the control group(P<0.05).(3)Renal function:There was no statistically significant difference between the observation group and the control group in urea nitrogen and serum creatinine levels.(4)Prognosis: The duration of intubation in the observation group was only(1.55 ± 0.69)days,while the duration of intubation in the control group was(4.95 ±2.35)days.The duration of intubation in the observation group was significantly shorter(P=0.008).The detention time of ICU in the observation group was(6.45±2.04)days,and that in the control group was(10.35±1.35)days.The detention time of ICU in the observation group was significantly shorter(P<0.001).The incidence of delirium in the observation group was 5%,lower than 11.7% in the control group,but the difference was not significant.There was no significant difference in the discharge VTE score between the observation group and the control group,with an average of(5.20 ± 3.64)points in the observation group and(6.15 ± 0.99)points in the control group.Conclusion: Albumin priming solution can improve the inflammatory response caused by ECC,and has a good effect on reducing the time of patient intubation and the number of days in ICU.It is helpful to maintain the integrity of vascular endothelial glycocalyx and normal capillary permeability in adult cardiac surgery patients with ECC,and plays a role in protecting myocardium and reducing inflammation,thereby improving the prognosis of patients and improving the quality of treatment.