控制性低中心静脉压对肝部分切除术中酸碱平衡的影响  

Effect of Controlled low Central Venous Pressure on Acid-base Balance during Partial Hepatectomy

作　　者：黎奕旺 梁勇升[1] 黄今肇[1] 张武德 LI Yi-wang;LIANG Yong-sheng;HUANG Jin-zhao;ZHANG Wu-de(Department of Anesthesiology,the Sixth Affiliated Hospital of Guangxi Medical University,Guangxi 537000,China)

机构地区：[1]广西医科大学第六附属医院麻醉科,广西玉林537000

出　　处：《中国医药指南》2019年第12期16-18,共3页Guide of China Medicine

摘　　要：目的观察控制性低中心静脉压(CLCVP)对肝部分切除术中酸碱平衡的影响。方法选取需行肝部分切除术的患者60例,分为低中心静脉压肝部分切除术组(L组,低中心静脉压组,n=30)和正常中心静脉压肝部分切除术组(C组,正常中心静脉压组,n=30)两组。分别于麻醉用药前10 min(T_1)、开腹前10 min(T_2)、肝切除开始前10 min(T_3)、肝切除开始后30 min(T_4)、肝切除完成后10 min(T_5)及关腹前10 min(T_6)进行动脉血气分析及电解质检测,并记录切肝手术时间、术中出血量、输血量。结果在T_1～T_6的统计中,低中心静脉压组的pH、BE值与正常中心静脉压组的pH、BE值差异无统计学意义(P>0.05),低中心静脉压组切肝手术时间、术中出血量和输血量明显低于正常中心静脉压组(P<0.05)。结论实施控制性低中心静脉压对肝部分切除术中的酸碱平衡无明显影响,并且可以减少肝部分切除术的手术时间,明显减少肝部分切除术的出血量及输血量。Objective To investigate the effect of controlled low central venous pressure (CLCVP) on acid-base balance during partial hepatectomy .Methods Select need line of hepatectomy in patients with 60 cases, divided into low central venous pressure hepatectomy group (L group, low central venous pressure group, n=30) and normal central venous pressure hepatectomy group (C group,normal central venous pressure group, n=30). In 10 min before anesthesia (T1), 10 min before operation(T2), 10 min before the start of liver resection (T3), 30 min after liver resection to start (T4), 10 min after liver resection to complete (T5) and closed abdomen before 10 min (T6),arterial blood gas analysis and electrolyte detection were performed. and record cut liver operation time, intraoperative blood loss, blood transfusion amount. Results In T1 ~ T6 statistics, there was no significant difference between the pH and BE values in the low central venous pressure group and those in the normal central venous pressure group(P >0.05). The duration of the hepatectomy, the intraoperative blood loss And blood transfusion was significantly lower than the normal central venous pressure group (P <0.05). Conclusion Controlled low central venous pressure has no significant effect on acid-base balance during partial hepatectomy, and can reduce the operation time of partial hepatectomy and significantly reduce the amount of blood loss and blood transfusion after partial hepatectomy.

关 键 词：控制性低中心静脉压 肝部分切除术 酸碱平衡 

分 类 号：R657.3[医药卫生—外科学]