低中心静脉压在肝切除术中的应用  

Application of low central venous pressure in liver resection

作　　者：李启东[1] 周伟[1] 贾振庚[1] 

机构地区：[1]中日友好医院普外科,北京100029

出　　处：《中国综合临床》2012年第1期72-74,共3页Clinical Medicine of China

摘　　要：目的探讨低中心静脉压（LCVP）技术在肝切除手术中的可行性和有效性。方法将48例行肝切除术患者计算机随机分为两组，LCVP组术中维持中心静脉压（CVP）≤5cm H2O，肝切除后恢复正常CVP；对照组维持CVP6—12cmH2O。比较两组患者手术切除肝叶所需时间、术中出血量、输血量及术后肾功能。结果LCVP组与对照组肝切除所需时间为（45±8）、（35±5）min，失血量分别为（850±160）、（436±280）ml，术中出血量分别为（490±130）、（270±105）ml，差异均有统计学意义（t值分别为15．53、7．69、17．89，P〈0．05）；手术前后两组肾功能均无明显变化（P均〉0．05）。结论肝切除术中应用LCVP可明显缩短手术时间，减少术中出血量及输血量，且对肾功能无明显损害，有利于患者康复。Objective To investigate the feasibility and effectiveness of low central venous pressure （LCVP） in the operation of major hepatic resection. Methods Fourty-eight patients underwent major hepatic resection were randomized into two groups ： LCVP and control group. In the LCVP group, CVP was maintained ≤ 5 em H2O during the hepatic resection and then returned to normal after resection. In the control group, CVP was maintained normal between 6 -12 cm H2O. The duration of hepatectomy, volume of blood loss, volume of blood transfused and renal function were compared between the two groups. Results For the LCVP and control group, the time for hepatectomy was （45 ± 8 ） and （35 ± 5 ）rain, respectively;the volumes of blood loss were （850 ± 160） and （436 ±280）ml,respectively; the blood loss during operation was （490 ± 130） and （270 ± 105）ml respectively. The differences were statistically significant （t values were 15.53,7.69 and 17.89 separately, P 〈 0. 05 ）. No significant difference in the renal function was observed before and after the operation （ P 〉 0. 05 ）. Conclusion Using LCVP technique during liver resection significantly reduced the operation time, blood loss and blood infusion. And there was no obvious adverse effect on renal function. [ Key words ]

关 键 词：肝切除术 中心静脉压 肝癌 

分 类 号：R657.3[医药卫生—外科学]