Effect Of Human Albumin Infusion Rate On Hemodynamics Of Portal Hypertension Patients

Portal hypertension is a variety of causes obstruction of portal vein blood flow and (or) blood flow, resulting in portal vein and its tributaries increased intravascular pressure, associated with a group of collateral circulation Clinical syndrome, including ascites, esophageal-gastric variceal bleeding (EVB), hepatic encephalopathy, hepatorenal syndrome, hepatopulmonary syndrome, portal hypertensive gastropathy. Human albumin is one of the drugs used by liver cirrhosis patients, that cause the rise of portal vein pressure when injected too fast, and then induce bleeding. This study therefore assessed the effect of albumin injection on portal hypertension in liver cirrhosis patients. Liver cirrhosis patients were injected with human albumin and color doppler ultrasound was used to detect the change in portal vein hemodynamics. Doppler ultrasound which has certain value of clinical applications, provides an accurate and repeatable Quantitative index. Using this method to estimate the effect of injecting human albumin on portal hypertension with the appropriate speed has certain clinical value.Objectives:Using color doppler ultrasound diagnostic instrument to detect the changes in hemodynamic parameters when human albumin is injected into liver cirrhosis portal hypertension patients at different time, and discussing appropriate speed of injecting human albumin further。Method:A total of 58 patients who were treated in the first hospital of Jilin university from January 2010 to March 2011 were included in the study. The patients were randomly divided into two groups, conventional infusion care group (45minutes), and experimental group (30minutes).The experimental group consisted of 30 (25 male and 5 female) patients whose average age was 51.1 years. The Conventional group consisted of 28 (18 male and 10 female) patients whose average age was 48.75 years. A uniform static point albumin was used and ultrasound was used to detect the degree of portal vein bore (DPV), Vpv and estimate the change in portal hemodynamic parameters at three time points before injecting albumin and 15 minutes after injection. Measurement data were shown using mean±standard deviation (x±s) t test to detect the mean difference between the two samples. p<0.05 was considered statistically significant.Result:Comparing value of degree of bore of portal vein between 45 minutes group and 30 minutes group at four time points that injecting human albumin 0 minute,15 minutes,30 minutes and 45 minutes。If p>0.05, the statistical difference has no significant meaning。Comparing result of average Vpv between experiment group and conventional group at different time points we have mentioned。If p>0.05, the statistical difference has no significant meaning。Comparing portal vein blood flow between experiment group and conventional group at different time points。When p>0.05, the statistical difference has no significant meaning。Comparing portal vein pressure of the two sets of cases before and after injecting Static point human albumins。If p>0.05, the statistical difference has no significant meaning。Conclusion:(1) It should be slow that injecting human albumins for liver cirrhosis portal hypertension patiens at the beginning 15 minutes, the velocity is 15～20gtt/min。Observing 10 minutes, if there is no discomfort, wo can accelerate injecting velocity.(2) There is little change in portal vein pressure before and afer injecting albumin。(3) Comparison of two input 20% human serum albumin 50ml (including 10g) before and after the portal vein had no significant expansion, the average flow velocity no faster, no significant increase in blood flow.(4) Within 30 minutes to enter the portal hypertension in patients with human albumin 20% 50ml (including 10g) is feasible.Shortcomings:the small sample size issue, not the formation of large-scale clinical studies, the results have a certain bias, such as conditions permit,should increase the sample size in order to better improve the scientific reliability and validity; measurement Indicator than a single, human albumin failed to measure the splenic vein and superior mesenteric hemodynamics are affected; Sometimes patients do not want to measure, with communication difficulties.Outlook: In the 30 minutes to enter the portal hypertension in patients with human albumin 20% 50ml (including 10g) is appropriate, in future studies to get the exact number of drops; strengthen human care, to give psychological counseling, physical and psychological have been restored.