Objective To systematically evaluate the efficacy and safety of human albumin (HA) in patients undergoing thoracic and orthopedic surgery during the perioperative period.

Methods Databases including PubMed, Embase, Web of Science、Cochrane Library, China National Knowledge Infrastructure, VIP and WanFang Data were electronically searched. Studies concerning the efficacy and safety of HA for perioperative patients undergoing thoracic and orthopedic surgery were collected, with the search period from the inception to January 1, 2026. Two investigators independently screened studies, extracted data and assessed the quality of included studies. Meta-analysis was performed using RevMan 5.3 software.

Results A total of 6 studies involving 346 patients were included. Meta-analysis results showed that the overall effective rate [OR=4.09, 95%CI (1.51, 11.07), P<0.05) and the cure rate [OR=6.27,95%CI (1.71, 23.00), P<0.05) in the experimental group were significantly higher than those in the control group. The incidences of infection [OR=0.16, 95%CI (0.05, 0.53), P<0.05] and chest pain [OR=0.11, 95%CI (0.03, 0.39), P<0.05] in the experimental group were significantly lower than those in the control group. There was no statistically significant difference in the incidence of fever [OR=0.55, 95%CI (0.12, 2.51), P>0.05] between the two groups.

Conclusions Current evidence indicates that HA can improve the overall effective rate and cure rate, and reduce the risks of infection and chest pain in perioperative patients undergoing thoracic and orthopedic surgery, without increasing the incidence of fever. Limited by the quantity and quality of included studies, more high-quality studies are required to verify the above conclusions.

1. 付秀娟, 于玲. 人血白蛋白的适应症及临床获益[J].临床药物治疗杂志, 2018, 16(12):71-73. [FuXJ, YuL. Indications and clinical benefits of human serum albumin[J]. Journal of Clinical Pharmacotherapy, 2018, 16(12): 71-73.DOI: 10.3969/j.issn.1672-3384.2018.12.019.

2. QYResearch. QYResearch医疗健康研究中心2019年报告[EB/OL]. [2026-04-21] https://www.qyresearch.com.cn.

3. 纪光伟. 2024静脉注射白蛋白的国际输血医学协作指南解读[J]. 临床外科杂志, 2025, 33(1): 84-88.JiGW. Interpretation of the 2024 international guidelines for intravenous albumin administration in transfusion medicine[J]. Journal of Clinical Surgery, 2025, 33(1): 84-88. DOI: 10.3969/j.issn.1005-6483.20241943.

4. 中国药学会医院药学专业委员会, 《人血白蛋白临床应用管理中国专家共识》编写组. 人血白蛋白临床应用管理中国专家共识[J]. 中国医院药学杂志, 2024, 44(7): 739-751.Chinese Pharmaceutical Society Hospital Pharmacy Professional Committee; Editorial Group of the "Chinese Expert Consensus on Clinical Application Management of Human Serum Albumin". Chinese expert consensus on clinical application management of human serum albumin[J]. Chinese Journal of Hospital Pharmacy, 2024, 44(7): 739-751. DOI: 10.13286/j.1001-5213.2024.07.01.

5. KomangY. Guidelines for use of albumin. adapted from the original published guidelines developed by the university hospital consortium and published inarchives of internal medicine[EB/OL]. [2026-04-21] https://www.academia.edu/36404436/GUIDELINES_FOR_USE_OF_ALBUMIN.

6. 刘东华, 王路平, 李红, 等. 真实世界人血白蛋白用于心外科围术期有效性和安全性研究[J]. 中国医院药学杂志, 2025, 45(7): 799-803.LiuDH, WangLP, LiH, et al. A real-world study on the efficacy and safety of human albumin in the perioperative period of cardiac surgery[J]. Chinese Journal of Hospital Pharmacy, 2025, 45(7): 799-803. DOI: 10.13286/j.1001-5213.2025.07.10.

7. 张艳丽, 方维军, 陈坚. 我院人血白蛋白临床应用评价分析[J]. 临床误诊误治, 2018, 31(9): 34-37.ZhangYL, FangWJ, ChenJ. Clinical application evaluation and analysis of human serum albumin[J]. Clinical Misdiagnosis and Mismanagement, 2018, 31(9): 34-37. DOI: 10.3969/j.issn.1002-3429.2018.09.010.

8. 李慧博, 门鹏, 徐小元, 等. 人血白蛋白用于肝硬化治疗的快速建议指南的解读[J]. 临床药物治疗杂志, 2018, 16(12): 10-16.LiHB, MenP, XuXY, et al. Interpretation of the rapid guideline for the use of human serum albumin in the treatment of liver cirrhosis[J]. Journal of Clinical Pharmacotherapy, 2018, 16(12): 10-16. DOI: 10.3969/j.issn.1672-3384.2018.12.003.

9. HigginsJP, AltmanDG, GøtzschePC, et al. The Cochrane Collaboration's tool for assessing risk of bias in randomised trials[J]. BMJ, 2011, 343: d5928. DOI: 10.1136/bmj.d5928.

10. 林丰, 罗文东, 赵刚, 等. 人血白蛋白在创伤性骨折患者的应用[J]. 昆明医科大学学报, 2016, 37(9): 128-130.LinF, LuoWD, ZhaoG, et al. Application of human serum albumin in patients with traumatic fractures[J]. Journal of Kunming Medical University, 2016, 37(9): 128-130. DOI: 10.3969/j.issn.1003-4706.2016.09.031.

11. 肖瑶, 奉川程, 蒲俊勇. 血白蛋白用于外科手术后低蛋白血症的临床效益研究[J]. 系统医学, 2018, 3(14): 74-76.XiaoY, FengCC, PuJY. A study of the clinical efficacy of blood albumin in the management of postoperative hypoalbuminemia[J]. Systematic Medicine, 2018, 3(14): 74-76. DOI: 10.19368/j.cnki.2096-1782.2018.14.074.

12. 林坚青, 孔令校, 林春英, 等. 20%人血白蛋白胸腔内注射治疗顽固性气胸的临床应用研究[J]. 中国医药科学, 2013, 3(12): 57-58, 72.LinJQ, KongLX, LinCY, et al. Clinical application study of 20% human serum albumin intrapleural injection for refractory pneumothorax[J]. China Medical Science Journal, 2013, 3(12): 57-58, 72. DOI: CNKI:SUN:GYKX.0.2013-12-030.

13. 孔彦生, 朱炳祥. 胸腔内注射20%人血白蛋白在难治性气胸治疗中的应用[J]. 深圳中西医结合杂志, 2019, 29(13): 123-125.KongYS, ZhuBX. Application of intrapleural injection of 20% human serum albumin in the treatment of refractory pneumothorax[J]. Shenzhen Journal of Integrated Traditional Chinese and Western Medicine, 2019, 29(13): 123-125. DOI: 10.16458/j.cnki.1007-0893.2019.13.060.

14. 蒲晓雯, 王雅娴, 陈瑞宜. 静脉输注人血白蛋白对老年气胸患者的疗效分析[J]. 中国实用医药, 2020, 15(7): 156-158.PuXW, WangYX, ChenRY. Analysis of the therapeutic efficacy of intravenous infusion of human serum albumin in elderly patients with pneumothorax[J]. China Practical Medicine, 2020, 15(7): 156-158. DOI: 10.14163/j.cnki.11-5547/r.2020.07.068.

15. 许恒, 代尊强. 胸腔内注射20%人血白蛋白在难治性气胸中的应用价值[J]. 医学食疗与健康, 2020, 2(4): 114-116.XuH, DaiZQ. The clinical application value of intrapleural injection of 20% human serum albumin in refractory pneumothorax[J].  Medical Nutrition Therapy & Health, 2020, 2(4): 114-116. DOI: CNKI:SUN:YXSL.0.2020-04-081.

16. 蒙龙, 王宁, 冯然, 等. 应用国际指南评价某院外科住院患者人血白蛋白临床使用情况[J]. 中国药房, 2016, 27(29): 4061-4063.MengL, WangN, FengR, et al. Evaluation of the clinical use of human serum albumin in surgical inpatients at a certain hospital based on international guidelines[J]. China Pharmacy, 2016, 27(29): 4061-4063. DOI: 10.6039/j.issn.1001-0408.2016.29.08.

17. 孙梦寒, 茆梦, 孙杰. 术前低白蛋白血症与肺切除术后肺部并发症的关系[J]. 中华麻醉学杂志, 2020, 40(7):795-799.SunMH, MaoM, SunJ. The relationship between preoperative hypoalbuminemia and pulmonary complications following lung resection[J]. Chinese Journal of Anesthesiology, 2020,40(7): 795-799. DOI: 10.3760/cma.j.cn131073.20200322.00707.

18. 张静静, 金旭婷, 李若寒, 等. ICU住院期间平均血清白蛋白水平和患者预后的相关性分析———一项多中心回顾性队列研究[J]. 中国急救医学, 2022, 42(6): 477-480.ZhangJJ, JinXT, LiRH, et al. Correlation analysis between average serum albumin levels during ICU admission and patient prognosis: a multicenter retrospective cohort study[J]. Chinese Journal of Emergency Medicine, 2022, 42(6): 477-480. DOI: 10.3969/j.issn.1002-1949.2022.06.003.

19. 李慧博. 白蛋白在液体复苏中的应用简述[J]. 临床药物治疗杂志, 2018, 16(12): 65-66.LiHB. A brief overview of the application of albumin in fluid resuscitation[J]. Journal of Clinical Pharmacotherapy, 2018, 16(12): 65-66. DOI: 10.3969/j.issn.1672-3384.2018.12.016.

20. 欧阳生珀, 童荣生. 人血白蛋白的合理应用概述[J]. 中国医院药学杂志, 2021, 41(4): 425-429.OuyangSP, TongRS. An overview of the rational application of human serum albumin[J]. Chinese Journal of Hospital Pharmacy, 2021, 41(4): 425-429. DOI: 10.13286/j.1001-5213.2021.04.18.

21. KrishnamoorthyV, MotikaCO, OhnumaT, et al. Perioperative colloid choice and bleeding in patients undergoing musculoskeletal surgery: an observational administrative database study[J]. Int J Crit Illn Inj Sci, 2021, 11(4): 223-228. DOI: 10.4103/IJCIIS.IJCIIS_178_20.

22. FujitaT, OkadaN, HorikiriY, et al. Safety and efficacy of hydroxyethyl starch 6% 130/0.4/9 solution versus 5% human serum albumin in thoracic esophagectomy with 3-field lymph nodes dissection[J]. Surg Today, 2019, 49: 427-434. DOI: 10.1007/s00595-018-1752-6.

23. ChahrourMA, KharroubiH, Al TannirAH, et al. Hypoalbuminemia is associated with mortality in patients undergoing lower extremity amputation[J]. Ann Vasc Surg, 2021, 77: 138-145. DOI: 10.1016/j.avsg.2021.05.047.

24. ChangSH, TsaiYJ, ChouHH, et al. Clinical predictors of long-term outcomes in patients with critical limb ischemia who have undergone endovascular therapy[J]. Angiology, 2014, 65(4): 315-322. DOI: 10.1177/0003319713515544.

25. ZhangS, SiH, XieJ, et al. Incidence and risk factors associated withhuman albumin administration followingtotal joint arthroplasty: a multicenterretrospective study[J]. J Orthop Surg Res, 2021, 16(1): 643. DOI: 10.1186/s13018-021-02642-9.

26. QiJ, LiuC, ChenL, et al. Postoperative serum albumin decrease independently predicts delirium in the elderly subjects after total joint arthroplasty[J]. Curr Pharm Des, 2020, 26(3): 386-394. DOI: 10.2174/1381612826666191227153150.

27. ZhangJ, ZhangZT, ShiTL. Single-center analysis of the inappropriate use of human albumin and nutritional support in hospitalized patients with hypoproteinemia in China[J]. J Int Med Res, 2021, 49(3): 1-12. DOI: 10.1177/0300060520987731.

28. ZhangF, LiuX, TanZ, et al. Effect of postoperative hypoalbuminemia and supplement of human serum albumin on the development of surgical site infection following spinal fusion surgery: a retrospective study[J]. Eur Spine J, 2020, 29(7): 1483-1489. DOI: 10.1007/s00586-020-06306-w.

29. 李志浩, 胡允腾, 张福. 术后低白蛋白血症与补充人血白蛋白对腰椎内固定术后发生切口愈合不良的影响[J]. 中华医学杂志, 2020, 100(11): 848-852.LiZH, HuYT, ZhangF. Effect of postoperative hypoalbuminemia and supplement of human serum albumin on the development of poor wound healing following lumbar internal fixation surgery[J]. National Medical Journal of China, 2020, 100(11): 848-852. DOI: 10.3760/cma.j.cn112137-20190613-01347.

30. LiumbrunoGM, BennardelloF, LattanzioA, et al. Recommendations for the use of albumin and immunoglobulins[J]. Blood Transfus, 2009, 7(3): 216-234. DOI: 10.2450/2009.0094-09.

31. YuYT, LiuJ, HuB, et al. Expert consensus on the use of human serum albumin in critically ill patients[J]. Chin Med J (Engl), 2021, 134(14): 1639-1654. DOI: 10.1097/CM9.0000000000001661.

32. 赵浩南, 陈纪宏, 白朝辉, 等. 人血白蛋白对肝硬化肝性脑病患者氧化应激反应影响[J]. 临床军医杂志, 2024, 52(9): 965-967.ZhaoHN, ChenJH, BaiCH, et al. The effect of human serum albumin on the oxidative stress response in patients with liver cirrhosis and hepatic encephalopathy[J]. Journal of Clinical Military Medicine, 2024, 52(9): 965-967. DOI: 10.16680/j.1671-3826.2024.09.24.