经腹全肝血流阻断巨大肝肿瘤切除术血液动力学的调控  

CLINICAL STUDY ON STABLE HEMODYNAMIC DURING ANESTHESIA FOR MAJOR LIVER RESECTION WITH TOTAL HEPATIC VASCULAR EXCLUSION

作　　者：顾尔伟[1] 刘学胜[1] 张野[1] 张健[1] 戴秀萍[1] 吴蓉蓉[1] 

机构地区：[1]安徽医科大学附属医院麻醉科,合肥230022

出　　处：《肝胆外科杂志》2000年第5期333-335,共3页Journal of Hepatobiliary Surgery

摘　　要：目的　探讨全肝血流阻断 (THVE)巨大肝肿瘤切除术围麻醉期血液动力学的调控措施。方法　 10例全肝血流阻断下巨大肝肿瘤切除术病人 ,用多巴胺 (3～ 5 μg·kg- 1· min- 1 )支持心血管功能 ,阻断前输血补液 ,提高中心静脉压至 1.2 k Pa水平 ,采用Swan- Ganz导管技术监测围麻醉期血液动力学变化。结果　肝血流阻断后 ,CVP下降 (2 7.6 % ) ,HR增快 ,SVRI增加 (2 4.3% ) ,CI(17.8% )和 L VSWI(2 2 .6 % )明显下降 ,MAP仅下降 14.3% ,以阻断 5 min为甚 ,肝血流开放后 ,各参数均恢复稳定。结论　小剂量多巴胺支持循环 ,阻断前提高 CVP,阻断后快速输血补液 ,是防止Objective To investigate the management for stable hemodynamic during the anesthesia for hepatectomy with of total hepatic vascular exclusion(THVE).Methods THVE have been performed in ten patients with massive liver tumors.The small dose of dopamine (3～5μg·kg -1 ·min -1 )infusion was administered.CVP was elevated to 1.2kPa before blood blockade.Hemodynamic variables were observed by Swan-Ganz catheter monitoring during anesthesia.Results Hemodynamic parameters were satisfactorily controlled during anesthesia except a very short time (5～10min) after THVE with CVP(27.6%)、CI(17.8%)、LVSWI(22.6%)and MAP(14.3%) low down.Conclusion Small dose of dopamine infusion,elevated CVP before THVE and rapid infusion blood after THVE may be the effective contrlling the procedures for major liver resection with THVE.

关 键 词：全肝血流阻断 血液动力学 麻醉 肝肿瘤 切除术 

分 类 号：R735.705[医药卫生—肿瘤] R614.2[医药卫生—临床医学]