低中心静脉压麻醉联合选择性肝左、右动脉阻断对肝叶切除术出血的影响  

Influence of low central venous pressure anesthesia combined with selective right or left hepatic arterial regional blockade on bleeding after hepatic lobectomy

作　　者：郭强[1] 梁智强[1] 邢祖民[1] 

机构地区：[1]广东省佛山市顺德区第一人民医院,528300

出　　处：《临床合理用药杂志》2009年第13期27-28,共2页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的观察低中心静脉压麻醉联合选择性肝左、右动脉阻断对肝叶切除术出血的影响。方法24例择期肝叶切除患者,随机分为2组:低中心静脉压联合选择性肝左、右动脉阻断组(S组)和低中心静脉压组(LCVP组),每组12例。2组在肝实质完全离断过程中控制中心静脉压(CVP)在0～5cmH2O。比较2组患者手术总出血量、肝动脉阻断时间、围术期输血例数、术后24h肾功能的变化。结果S组手术总出血量、围术期输血例数明显少于LCVP组(P<0.05);2组肝动脉阻断时间、术后24h肾功能无明显影响(P>0.05)。结论低中心静脉压麻醉联合选择性肝左、右动脉阻断较单纯低中心静脉压可减少肝叶切除术出血和输血,对肾功能无明显影响。Objective To observe the influence of low central venous pressure anesthesia combined with selective right or left hepatic arterial regional blockade on bleeding after hepatic lobectomy. Methods 24 patients undergoing hepatecto- my were randomly divided into two groups：low central venous pressure combined with selective right or left hepatic arterial re- gional blockade group （S group） and low central venous pressure group （LCVP group） ,12 cases of each group. Liver parenchyma in the two groups completely control the process of breaking away from the central venous pressure （CVP） in 0 ～ 5cm H20. Comparing the two groups the total amount of bleeding in patients with hepatic artery occlusion time, perioperative blood transfusion a few cases, after a 24-hour changes in renal function. Results Low central venous pressure combined with selective right or left hepatic arterial regional blockade group the total amount of bleeding surgery, perioperative blood transfusion were significantly less than the low central venous pressure group;two hepatic artery occlusion time ,24 hours after renal had no significant effect. Conclusion Low central venous pressure anesthesia combined with selective right or left hepatic arterial regional blockade can reduce bleeding and transfusion, and is not infuencial on renal function.

关 键 词：低中心静脉压 选择性肝动脉阻断 肝叶切除术 出血量 肾功能 

分 类 号：R614.24[医药卫生—麻醉学]