肝段切除术围术期动脉血乳酸浓度和桡动脉压的变化  

The Changs of Arterial lactate Concentrations and Radial Artery Pressure in Segment Hepatectomy Perioperative

作　　者：毕振华[1] 毕晓琳[2] 李忠斌[3] 任波[1] 徐晨[1] 米卫东[4] 王赛[1] 

机构地区：[1]解放军302医院麻醉手术中心,北京100073 [2]青岛大学附属医院营养科,山东青岛266003 [3]解放军第302医院肝纤维化诊疗中心,北京100039 [4]解放军总医院麻醉手术中心,北京100853

出　　处：《现代生物医学进展》2012年第26期5109-5112,共4页Progress in Modern Biomedicine

摘　　要：目的:观察肝细胞癌合并肝炎肝硬化患者行肝段切除术围术期动脉血乳酸浓度,及肝门阻断、开放后有创血压的变化。方法:选择择期行肝段切除术的肝硬化患者30名,给予全凭静脉麻醉,于手术开始前、第一肝门阻断开放即时、阻断开放后15min,分别采取动脉血化验血乳酸浓度,记录采取动脉血时血压值及开放后血压最低值,设计为自身前后对照,应用CHISS软件进行统计学分析。结果:开放即时与开放后15min动脉血乳酸浓度与术前比较均有明显统计学差异(P<0.05),乳酸浓度与肝门阻断时间呈正相关,开放即时与开放后动脉血乳酸浓度相比无明显统计学差异(P>0.05)。开放后血压下降程度与乳酸浓度无明显相关,与阻断时间无明显相关。肝门阻断前后及开放后15min患者血红蛋白无明显变化(P>0.05)。结论:肝段切除术围术期行第一肝门阻断后血乳酸浓度明显升高,肝脏再灌注期间乳酸未进一步升高,甚至有所降低。开放后血压下降程度与乳酸浓度无明显相关。Objective： To evaluate perioperative lactic acid concentration of arterial blood in hepatectomy for hepatocellular carcinoma patients with cirrhosis,and the radial artery invasive blood pressure when the porta hepatis was blocked and reopened. Methods： Thirty hepatocellular carcinoma patients with cirrhosis undergoing elective hepatectomy wer e ehoosed and given total intravenous anesthesia. Arterial blood samples were collected to test the lactic acid concentration before surgery, porta hepatis blocked, 15minutes after porta hepatis reopened and record arterial blood pressure when taking the blood samples and the lowest blood pressure after porta hepatis reopened. Before and after control for their own design, apply CHISS software for statistical analysis. Results： Arterial blood lactic acid concentration when 15min after porta hepatis reopened and open real-time was significantly high compared with their levels before surgery, and was positively correlated with porta hepatis blocked time. There were no difference in the amount of intraoperative bleeding between before and after the reopened, so in the concentration of lactic acid. Conclusion： Perioperative lactic acid concentration of arterial blood in hepatectomy iurcreased significantly after porta hepatis blocked, but the latic acid didn＇t further increase or even declined during liver reperfusion. The extent of decline in blood pressure has no significant correlation with the lactic acid concentration and blocked time.

关 键 词：肝硬化 肝段切除术 血乳酸 桡动脉压 

分 类 号：R735.7[医药卫生—肿瘤]