目标导向液体治疗下控制性低中心静脉压技术在肝脏手术中应用  

The application of controlled low central venous pressure technologyr under target-directed fluid therapy in liver surgery

作　　者：林靖 陈良巧 周艳瑾 应海峰 Lin Jing

机构地区：[1]浙江省温岭市中医院,317500 [2]浙江省台州医院,317000

出　　处：《浙江临床医学》2022年第11期1612-1614,共3页Zhejiang Clinical Medical Journal

基　　金：浙江省台州市A类科技计划项目(21ywa56)。

摘　　要：目的探讨目标导向液体治疗下控制性低中心静脉压(CLCVP)技术在肝脏手术中的应用。方法选取2020年2月至2021年2月腹腔镜肝脏手术患者100例,依据干预方法分为CLCVP液体治疗组(L组)、目标导向液体治疗下CLCVP组(LG组)两组,各50例。分析两组血流动力学、动脉血气、围术期指标、术后并发症发生情况。结果切除肝脏前5min(T1)、切除肝脏后5min(T2)时,LG组患者中心静脉压(CVP)均低于L组(P<0.05),心率(HR)均高于L组(P<0.05),手术时间短于L组(P<0.05),肝门阻断时间长于L组(P<0.05),术中补液量、术中出血量、术中输血量均少于L组(P<0.05),术中尿量多于L组(P<0.05),切除肿瘤重量低于L组(P<0.05),PACU停留时间短于L组(P<0.05),胃肠功能恢复时间短于L组(P<0.05),术后住院时间短于L组(P<0.05),总住院时间短于L组(P<0.05),术后并发症发生率36.00%低于L组56.00%(P<0.05)。结论肝脏手术中,与常规控制性低中心静脉压技术干预相比,目标导向液体治疗下控制性低中心静脉压技术的应用效果较好。Objective To observe the application of controlled low central venous pressure(CLCVP)technology under target-directed fluid therapy in liver surgery.Methods 100 patients who received laparoscopic liver surgery in the Zhejiang Taizhou Hospital February from 2020 to February 2021 were selected,according to the intervention method,they were divided into CLCVP group(L group)and CLCVP under target-directed fluid therapy group(LG group),with 50 cases in each group.The perioperative indicators and postoperative complications of the two groups were analyzed.Results At 5 min(T1)and 5 min(T2),the CVP of the LG group was lower than the L group(P<0.05)and the heart rate(HR)was higher than the L group(P<0.05).The operation time of the patients in the LG was shorter than that in the L group(P<0.05).The hilar block time was longer than that in the L group(P<0.05).The intraoperative fluid supplementation was less than that of the L group(P<0.05).The intraoperative urine output was greater than that in the L group(P<0.05)The intraoperative bleeding was less than that in the L group(P<0.05).The intraoperative blood transfusion was less than that in the L group(P<0.05).The weight of the resection tumor was lower than that in the L group(P<0.05).PACU stayed shorter than the L group(P<0.05).The recovery time of gastrointestinal function was shorter than that of the L group(P<0.05).The postoperative hospital stay was shorter than that in the L group(P<0.05).The total hospitalization time was shorter than that in the L group(P<0.05).The postoperative complication rate of patients in the LG group was 36.00%lower than 56.00%in the conventional intervention group(P<0.05).Conclusion The application effect of the controlled low-central venous pressure technique under goal-oriented fluid therapy in liver surgery is betterthantheconventional intervention.

关 键 词：肝脏手术 目标导向液体治疗 控制性低中心静脉压技术 

分 类 号：R614[医药卫生—麻醉学]