控制性低中心静脉压在肝脏手术中的应用

摘要

Objective To study the application of controlled low central venous pressure (CLCVP) in liver operation.Methods 138 patients undergoing liver resection at our hospital from April,2013 to September,2015 were selected as study objects and were randomly divided into an observation group and a control group,69 cases for each group.The observation group were given CLCVP and the control group conventional anesthesia.The intra-operative bleeding volume,intra-operative infusion volume,hepatic portal occlusion time,operation time,and post-operative glutamic-pyruvic transaminase level were compared between these two groups.Results The intra-operative bleeding volume,intra-operative infusion volume,hepatic portal occlusion time,operation time,and post-operative glutamic-pyruvic transaminase level were (364.37±243.81) ml,(1 438.49±237.22) ml,(14.39±5.83) min,(138.25±46.73) min,and (138.92±46.73) U/L in the observation group and were (692.43±312.26) ml,(1 909.67±416.43) ml,(21.53±6.21) min,(183.47±62.54) min,and (187.43±54.12) U/L in the control group (P ＜ 0.05).Conclusions CLCVP is effective in reducing the bleeding volume during liver operation,improving the curative effect,reducing damage to liver function,and accelerating the patients' recovery,so it is worth being clinically generalized.%目的 研究控制性低中心静脉压在肝脏手术中的应用.方法 选取2012年4月至2015年9月于本院行肝切除手术治疗的患者138例为研究对象,将其随机分为观察组和对照组,每组69例.观察组采用控制性低中心静脉压技术,对照组采用常规麻醉术.比较两组术中出血量、术中输液量、肝门阻断时间、手术时间和术后谷丙转氨酶水平.结果 观察组术中出血量、术中输液量、肝门阻断时间、手术时间分别为(364.37±243.81) ml、(1 438.49±237.22)ml、(14.39±5.83)min、(138.25±46.73)min,显著少于或短于对照组的(692.43±312.26) ml、(1 909.67±416.43) ml、(21.53±6.21) min、(183.47±62.54) min (P＜0.05).观察组术后7d谷丙转氨酶水平为(138.92±46.73) U/L,显著低于对照组的(187.43±54.12) U/L (P＜0.05).结论 控制性低中心静脉压技术有利于减少肝脏手术过程中的出血量,提升手术治疗效果,减小对肝功能的损伤,加快患者康复,值得临床应用和推广.