控制性低中心静脉压应用于肝切除术的麻醉护理  

Anesthesia Care of Controlled Low Central Venous Pressure in Hepatectomy

作　　者：卢春丽[1] 黄德辉[1] 谢海辉[1] 石海燕[1] 张曙[1] 

机构地区：[1]广东省东莞市人民医院麻醉科,广东东莞523000

出　　处：《赣南医学院学报》2016年第1期138-140,142,共4页JOURNAL OF GANNAN MEDICAL UNIVERSITY

基　　金：广东省东莞市科技计划医疗卫生类项目(201010515000078)

摘　　要：目的：探讨低中心静脉压技术应用于肝切除术患者的围手术期护理。方法：选择2010年1月~2012年1月择期行肝切除术的患者66例,分成对照组和低中心静脉压组（LCVP组）各33例。观察患者术中尿量、液体输入量、失血量、输血量,并比较两组患者凝血功能和血小板的差异。结果：LCVP组术中晶体输入量和出血量明显减少,手术时间缩短（P〈0.05）,而两组的胶体输入量和尿量无明显差异;两组患者术后24 h的血小板计数（PLT）、凝血酶原时间（PT）、活化部分凝血酶原时间（APTT）、纤维蛋白原定量（FIB）,有显著性差异（P〈0.05）。结论：控制性低中心静脉压技术可减少肝切除术中出血量,维持凝血功能,保护血小板。护士积极配合麻醉医生,加强围手术期护理,对顺利完成手术,保障患者手术安全和减少并发症有重要意义。Objective： To investigate the application of anesthesia care of controlled low central venous pressure in hepatectomy. Methods： Average urine volume,the volume of fluid input,bleeding volume and transfusion volume during the operation were analyzed in 66 cases that underwent hepatectomy in our hosipital from January 2010 to January 2010. 66 patients were divided into control group（ 33 cases） and low central venous pressure（ LCVP） group（ 33 cases）. The differences of blood coagulation function and platelet in two groups were compared with. Results： The volume of crystalloid input,the bleeding volume and operation time were decreased significantly in group LCVP（ P〈0. 05）,but there was no difference with the volume of urine and colloid input between two groups during the operation. There were significant differences with the platelet count（ PLT）,prothrombin time（ PT）,activated partial prothrombin time（ APTT）,fibrinogen（ FIB）（ P〈0. 05） between two groups within 24 hours after the surgery. Conclusion： Application of controlled low central venous pressure canreduce blood loss in hepatectomy,maintain blood coagulation function and protect platelets.To actively cooperate with the anesthesiologist,to strengthened the perioperative nursing are significant to have a successful operation,to ensure patient safety and to reduce complications.

关 键 词：控制性低中心静脉压 肝切除术 围手术期护理 

分 类 号：R473.6[医药卫生—护理学]