目的 探讨肝叶切除术中应用急性高容量血液稀释(AHHD)联合低中心静脉压(LCVP)减少出血量的临床效果.方法 肝叶切除术患者60例,ASAⅠ或Ⅱ级,随机均分为三组,分别对患者实施LCVP(A组)、AHHD(B组)及LCVP联合AHHD(C组),并连续监测SBP、DBP、MAP、CVP.术中采集中心静脉血及桡动脉血测定Hb,并检查三组术中出血量.结果 与麻醉诱导后比较,肝实质阻断前后及手术结束时三组Hb均明显降低(P＜0.01).B组肝实质横断时出血量及总出血量明显高于A、C组(P＜0.01).结论 LCVP联合AHHD应用于肝叶切除术中能够减少术中出血量,且对氧供需平衡无影响.%Objective To investigate the feasibility and safety of the application of acute hypervolemic hemodilution combined with low central venous pressure in hepatic resectioa Methods Sixty ASA Ⅰ orⅡ patients scheduled for elective hepatic resection were randomly divided into 3 groups with 20 cases each Low central venous pressure was performed in group A, acute hypervolemic hemodilution was performed in group B, and both techniques were performed in group C. SRP, DBP, MAP and CVP were continuously monitored. Blood was withdrawn from the central vein and radial artery to assess hemoglobin. Intraoperative hlood loss volume was also recorded. Results Hemoglobin was significantly lower before and after liver parenchyma resection as well as at the end of operation than after anesthesia induction (p< 0. 01). Blood loss during resection and total blood loss in group B were significantly more than those in the group A and C (P<0. 01). Conclusion I.ow central venous pressure combined with acute hypervolemic hemodilution can reduce intraoperative blood loss without affecting the oxygen supply-demand balance during hepatic resection.
展开▼
