Analysis Of The Influencing Factors Of Hypoproteinemia In Patients After Non Digestive Tract Operation In Thoracic Surgery

Objective The purpose of this study was to investigate the main risk factors for hypoproteinemia in patients undergoing non digestive tract operation after thoracic surgery.Methods The study selected 317 patients with pulmonary tumors,mediastinal tumors,and bullous bulges who underwent surgical treatment for these patients admitted to the general thoracic surgery from May 2018 to December 2018.According to the results of the biochemical examination on the first day after the operation,the above cases were divided into the hypoproteinemia group(ALB <35g/L)and the control group(ALB ?35g/L).With reference to relevant literature and clinical experience,statistical clinical data include: general conditions(gender,age,weight),basic disease conditions(hypertension,diabetes),pre-operative pulmonary infection,pre-operative and postoperative first-day serum Albumin concentration(serum albumin,ALB),operation time,operation method,intraoperative blood loss,lymph node dissection,intraoperative fluid replacement(total infusion volume,crystal volume,colloid volume),postoperative fever time and maximum temperature,total thoracic drainage in the first three days after operation,postoperative pulmonary infection,postoperative hospital stay.SPSS 26.0 software was used for statistical analysis.Chi-square test was used for counting data.Univariate analysis was performed using t-test or analysis of variance for measurement data.Binary multivariate logistic regression analysis was performed on meaningful data to analyze the risk factors of hypoproteinemia after surgery.Then the Spearman rank correlation analysis was used to analyse the relationship between the magnitude of the decrease in albumin after the operation and the blood loss during the operation,the operation time,and the fluid replacement during the operation(total fluidreplacement,crystal volume,and colloid volume).Significant data were analyzed by multiple linear regression to obtain predictors of the magnitude of albumin decline after surgery.Results A total of 317 patients who underwent non-digestive tract surgery in thoracic surgery in our hospital were collected,including 178 males and 139 females,and the age ranged from 5 to 85 years,with an average of(52.3 ± 15.6)years.Hypoproteinemia(ALB<35g / L)occurred in 189 patients(59.6%).Among them,211 cases of lung tumors,145 cases of hypoalbuminemia(68.7%);50 cases of mediastinal tumors,20 cases of hypoalbuminemia(40%);56 cases of bullae,24 cases of hypoalbuminemia(42.9%).Patients' serum albumin levels decreased significantly after surgery,from(41.7 ± 3.7)g / L to(33.8 ± 4.1)g / L.The degree to which the serum albumin level of the patients decreased after the operation,that is,the difference between the serum albumin level before the operation and the serum albumin level after the operation was(7.9 ± 4.2)g / L.The univariate analysis results showed that:There was a statistically significant difference between the two groups in terms of age,preoperative serum albumin level,operation time,surgical method,with or without lymph node dissection,intraoperative blood loss / weight,total fluid volume / weight,crystal volume/ weight and colloid volume / weight(p <0.05).There was no statistically significant difference between the two groups in terms of gender,whether it was associated with hypertension,whether it was associated with diabetes,and whether there was a preoperative pulmonary infection(p> 0.05).Multivariate Logistic regression analysis results showed that age,preoperative albumin levels,preoperative combined pulmonary infections,blood loss /weight and colloidal fluid / weight were independent factors affecting hypoalbuminemia in patients undergoing non digestive tract operation in thoracic surgery.Spearman rank correlation analysis showed that the blood loss during the operation,the operation time,the total infusion volume / weight,the crystal fluid volume / weight and the colloid fluid volume /weight were positively correlated with the serum albumin levels before and after the operation(P values were all <0.001),and all showed a low correlation(r <0.4).The results of multiplelinear regression analysis showed that: blood loss / body weight and total fluid volume / body weight during operation were predictors of the decline in serum albumin levels.Conclusion 1.Serum albumin levels in patients after non-digestive tract surgery in thoracic surgery decreased significantly,and the incidence of hypoalbuminemia was higher at approximately 59.6%.Among them,the incidence of hypoalbuminemia after pulmonary tumors was 68.7%,and the incidence of hypoproteinemia after mediastinal tumors was 40%,and the incidence of hypoproteinemia after pulmonary bullae was 42.9%.2.Age,preoperative albumin level,preoperative combined pulmonary infection,intraoperative blood loss / body weight and intraoperative colloid input / body weight are independent risk factors for hypoalbuminemia after non digestive tract operation in thoracic surgery.3.Intraoperative blood loss / body weight and total fluid volume / body weight are predictors of the decline in serum albumin levels in patients undergoing non digestive tract operation in thoracic surgery.