外科理论与实践2012，Vol.17Issue(2)：135-138,4.DOI:10.3969/j.issn.1007-1096.2012.02.011
肝移植中肝脏左旋显露手法对血流动力学的影响
Liver left-rotating revelation maneuver and its effects on inferior vena cava in liver transplantation
金佳斌 1詹茜 1彭承宏 1任家俊 1沈柏用 1陈皓 1邓侠兴 1祝哲诚 1程东峰 1谢俊杰 1申川1
作者信息
- 1. 上海交通大学医学院附属瑞金医院外科,上海200025
- 折叠
摘要
Abstract
Objective To investigate the safety and efficiency of liver left-rotating revelation maneuver by observing the pressure of inferior vena cava (IVC) and monitoring other hemodynamic parameters during liver resection stage in liver transplantation. Methods Eighteen patients were subjected to selective orthotopic liver transplantation. The hemodynamic parameters were measured including IVC pressure, central venous pressure and mean arterial pressure during liver left-rotating stage after opening the abdominal cavity. We also respectively recorded preoperative and postoperative serum creatinine, urea nitrogen levels and urine output. Results All the 18 transplantations were successfully preceded. Patients were well recovered without major complications. The heart rate, IVC pressure increased after liver rotation, while the renal perfusion pressure decreased significantly. The IVC and renal perfusion pressure did not change during the first rotating stage, whereas, they changed significantly during the second rotating stage. There was no change for the other hemodynamic parameters. Conclusions Liver left-rotating revelation maneuver is a safe and efficient way for exposing the right lobe and retro-hepatic IVC. It can avoid rupture in retro-hepatic inferior vena cava by conventional method and will not result in drastic fluctuation in systemic hemodynamic. This method can also protect the patients from postoperative renal function injury or failure.关键词
肝脏/肝移植/肝脏左旋显露手法/下腔静脉Key words
Liver/ Liver transplantation/ Liver left-rotating revelation maneuver/ Inferior vena cava分类
医药卫生引用本文复制引用
金佳斌,詹茜,彭承宏,任家俊,沈柏用,陈皓,邓侠兴,祝哲诚,程东峰,谢俊杰,申川..肝移植中肝脏左旋显露手法对血流动力学的影响[J].外科理论与实践,2012,17(2):135-138,4.
