摘要
目的探讨控制性低中心静脉压对精准肝脏切除手术患者术中出血量和术后转归的影响。方法择期行精准肝脏切除手术患者40例,随机分成对照组和低中心静脉压(LCVP)组。LCVP组患者在肝脏切除期间通过调节体位、药物控制等方法维持中心静脉压(CVP)≤0.49 k Pa,对照组CVP不予干预。于麻醉诱导前5 min(T0)、肝脏切除前5min(T1)、肝脏切除后5 min(T2)、手术结束时(T3)行动脉血气分析,记录术中出血量、补液量等指标,观察术后胃肠功能恢复时间、术后并发症发生情况及术后住院时间等。结果两组患者基本资料比较差异无统计学意义。与对照组比较,LCVP组术中补液量明显减少(P<0.05),术中尿量明显增多(P<0.05),出血量差异无统计学意义。两组患者血气分析、术后胃肠功能恢复时间、术后住院时间及术后并发症发生率比较差异无统计学意义。结论控制性低中心静脉压未能显著减少精准肝脏切除手术患者术中出血量,对术后转归亦无明显影响。
Objective To investigate the effect of controlled low central venous pressure（ LCVP ） on intraoperative blood loss and postoperative outcome in patients undergoing precision liver resection. Methods Forty patients scheduled for precision liver resection were randomly divided into the control group and the low central venous pressure （ LCVP ） group. Patients in LCVP group were maintained CVP ≤ 0.49 kPa by the methods of adjusting the position and infusing drugs, the CVP of the patients in the control group was not intervened. Arterial blood gas was analyzed at five minutes before anesthesia induction （T0）, five minutes before liver resection （T1）, five minutes after liver resection（T2） , at the end of surgery（ T3 ）. Intraoperative blood loss volume and fluid infusion volumes were recorded. Recovery time of postoperative gastrointestinal function, postoperative complications and postoperative length of hospital stay were observed. Results There was no significant difference in basic data between the control group and the LCVP group. Compared with the control group, fluid infusion volumes of the LCVP group decreased significantly （P 〈 0. 05 ） , intraoperative urinary volume of the LCVP group increased significantly （P 〈O. 05 ）. There were no significant differences in blood loss volume, blood gas analysis, recovery time of postoperative gastrointestinal function, postoperative complication rates and length of hospital stay between the two groups. Conclusion In patients undergoing precision liver resection, the technique of controlled low central venous pressure can not reduce the intraoperative blood loss volume and change the postoperative outcomes.
出处
《安徽医科大学学报》
CAS
北大核心
2016年第11期1672-1676,共5页
Acta Universitatis Medicinalis Anhui
基金
安徽省科技攻关计划项目(编号:1301042204)
关键词
控制性低中心静脉压
精准肝脏手术
术中出血量
术后转归
controlled low central venous pressure
precision liver resection
intraoperative blood loss volume
post-operative outcome
