低中心静脉压及正常中心静脉压肝左外叶切除术的临床对比  

Clinical comparison of low central venous pressure and normal central venous pressure in hepatic left lateral lobectomy

作　　者：龚华[1] 朱松[1] 刘伟[1] 戴华佳 候克柱 

机构地区：[1]上海市杨浦区市东医院外一科,上海200438

出　　处：《临床和实验医学杂志》2016年第22期2221-2223,共3页Journal of Clinical and Experimental Medicine

基　　金：上海市卫计委课题(编号:201440014)

摘　　要：目的对比低中心静脉压及正常中心静脉压肝左外叶切除术的临床效果。方法选取2014年5月至2016年5月收治的左肝良恶性占位病变患者80例,依据随机数字表法将这些患者分为低中心静脉压肝左外叶切除术组(低中心静脉压组,n=40)和正常中心静脉压肝左外叶切除术组(正常中心静脉压组,n=40)两组。对两组患者的切肝手术时间、出血量、尿量、晶体量及胶体量、血小板计数(PLT)、凝血酶源时间(PT)、活化部分凝血酶原时间(APTT)、纤维蛋白原定量(FIB)、丙氨酸氨基转移酶(ALT)、总胆红素(Tbil)、尿素氮(BUN)、肌酐(Cr)水平进行统计分析。结果低中心静脉压组患者的切肝手术时间显著短于正常中心静脉压组(P<0.05),出血量、晶体量均显著少于正常中心静脉压组(P<0.05),PLT、FIB水平均显著高于正常中心静脉压组(P<0.05),PT、APTT均显著长于正常中心静脉压组(P<0.05);两组患者手术后的ALT、TBIL水平均显著高于术前(P<0.05)。结论低中心静脉压肝左外叶切除术的临床效果较正常中心静脉压肝左外叶切除术好,值得临床推广应用。Objective To compare the clinical effects of low central venous pressure and normal central venous pressure in hepatic left lateral lobectomy. Methods 80 cases of patients with left hepatic benign and malignant lesions who were treated in our hospital from May 2014 to May 2016 were selected, these patients were divided into low central venous pressure hepatic left lateral lobeetomy group （low-Center venous pressure group, n = 40） and normal central venous pressure hepatic left lateral lobectomy group （normal central venous pressure group, n = 40） according to a random number table. The liver resection operation time, blood loss, urine output, crystals amount and colloidal amount, PLT, PT, APTr, FIB, ALT, TBIL, BUN, Cr levels of the two groups were analyzed. Results In the low central venous pressure group, the operative time was significantly shorter （ P 〈 0.05 ）, the bleeding amount, crystals amount were significantly less （ P 〈 0.05 ）, the PLT, FIB levels were significantly higher （ P 〈 0.05 ）, the PT, APTr were significantly longer than the normal central venous pressure group （ P 〈 0.05 ）. The ALT, TBIL levels after surgery of the two groups were significantly higher than those before surgery （ P 〈 0.05 ）. Conclusion The clinical effect of low central venous hepatic left lateral lobectomy is better than that of normal central venous pressure hepatic left lateral lobectomy.

关 键 词：肝左外叶切除术 低中心静脉压 正常中心静脉压 

分 类 号：R657.3[医药卫生—外科学]