不同水平控制性低中心静脉压下肝叶切除术中出血量的比较研究  

Comparative Study on Intraoperative Blood Loss of Patients Undergoing Hepatectomy under Diff erent Levels of Controlled Low Central Venous Pressure

作　　者：韩明芬[1] 秦海艳[1] 商瑜[1] Han Mingfen;Qin Haiyan;Shang Yu(Department of Anesthesiology,Binzhou People’s Hospital,Binzhou,Shandong 256600)

机构地区：[1]山东省滨州市人民医院麻醉科,山东滨州256600

出　　处：《科技与健康》2025年第4期85-88,共4页Technology and Health

摘　　要：分析不同水平控制性低中心静脉压下肝叶切除术患者的出血量差异。选取2022年1月—2024年9月82例行肝叶切除术的患者作为研究对象,随机将其分为A组(27例)、B组(28例)、C组(27例)。入选患者均采取相同的手术麻醉方案,A组术中中心静脉压维持在正常水平,B组中心静脉压维持在3~5 cmH_(2)O,C组中心静脉压维持在0~3 cmH_(2)O,比较三组各指标差异。结果显示,T_(2)、T_(3)、T_(4)时,A组患者的心率低于B组、C组(P<0.05);T_(2)、T_(3)、T_(4)时,A组患者的平均动脉压高于B组、C组(P<0.05);T_(2)、T_(3)、T_(4)时,A组患者的动脉血氧分压高于B组、C组(P<0.05),且B组患者的动脉血氧分压高于C组(P<0.05);A组患者的术中出血量多于B组、C组,术后并发症发生率高于B组、C组(P<0.05)。研究发现,控制性低中心静脉压可以减少肝叶切除术中出血量,将中心静脉压维持在3~5 cmH_(2)O可改善患者术中动脉血氧分压,可推广使用。To analyze the differences in intraoperative blood loss of patients undergoing hepatectomy under different levels of controlled low central venous pressure.A total of 82 patients who underwent hepatectomy from January 2022 to September 2024 were selected as the research objects and randomly divided into group A(27 cases),group B(28 cases)and group C(27 cases).All the selected patients adopted the same surgical anesthesia scheme.The central venous pressure of group A was maintained at the normal level during the operation,the central venous pressure of group B was maintained at 3~5 cmH_(2)O,and the central venous pressure of group C was maintained at 0~3 cmH_(2)O.The differences in various indicators among the three groups were compared.The results showed that at T_(2),T_(3) and T_(4),the heart rate of patients in group A was lower than that in group B and group C(P<0.05);at T_(2),T_(3) and T_(4),the mean arterial pressure of patients in group A was higher than that in group B and group C(P<0.05);at T_(2),T_(3) and T_(4),the arterial partial pressure of oxygen of patients in group A was higher than that in group B and group C(P<0.05),and the arterial partial pressure of oxygen of patients in group B was higher than that in group C(P<0.05);the intraoperative blood loss of patients in group A was more than that in group B and group C,and the incidence of postoperative complications was higher than that in group B and group C(P<0.05).The study found that controlled low central venous pressure can reduce the intraoperative blood loss during hepatectomy.Maintaining the central venous pressure at 3~5 cmH_(2)O can improve the arterial partial pressure of oxygen of patients during the operation,which can be widely used.

关 键 词：控制性低中心静脉压 肝叶切除术 术中出血量 

分 类 号：R614.24[医药卫生—麻醉学]