重庆医学Issue(33)：4457-4459,3.DOI:10.3969/j.issn.1671-8348.2014.33.013
控制性低中心静脉压在不同类型肝切除术中应用的回顾性研究
Retrospective study on the effect of controlled low central venous pressure in different types of hepatectomy surgeries
摘要
Abstract
Objective To investigate the effect of controlled low central venous pressure(CLCVP) on blood loss and prognosis in different types of hepatectomy .Methods Two hundred and fifty seven patients underwent standard hepatectomy ,half liver resec‐tion or irregular partial hepatectomy from January 2011 to December 2012 in the First Affiliated Hospital of Chongqing Medical U‐niversity were retrospectively studied .Patients treated with CLCVP during hepatectomy were attributed to the CLCVP group .CVP of these patients were lowed to below 5 cm H2 O by minimizing fluid infusion and one or both of the following maneuvers :posture adjustment ,nitroglycerin administration .Alpha agonists were used when necessary to maintain the mean arterial pressure MAP at ≥60 mm Hg .Other patients been maintained with normal level of CVP by adjusting fluid administration were included in normal CVP group (NCVP) .Blood loss and transfusion volume ,length of hospital stay of the two groups were compared ,and the effects of different surgery type on CLCVP blood protection were evaluated .Results In the patients underwent standard hepatectomy or half liver resection ,intraoperative blood loss and transfusion were not statistically different between the two groups .While in the pa‐tients underwent irregular partial hepatectomy ,the CLCVP group suffered less blood loss and transfusion(P<0 .05) .Percentage of the patients with less than 200 mL blood loss and no transfusion of concentrated red cell in CLCVP group was higher than that of in NCVP group(P<0 .05) .Differences between the two groups in postoperative hospital stay were with no significance in all the operation types(P>0 .05) .Conclusion The efficiency of CLCVP on blood protection during hepatectomy is influenced by the sur‐gery type ,the blood protection is found to be significant only in irregular partial hepatectomy .No relationship was found between CLCVP and postoperative hospital stay in all types of hepatectomy .关键词
降压,控制性/肝肿瘤/中心静脉压Key words
hypotension ,controlled/liver neoplasms/central venous pressure分类
医药卫生引用本文复制引用
魏珂,王正林,何开华,程波,律峰,闵苏..控制性低中心静脉压在不同类型肝切除术中应用的回顾性研究[J].重庆医学,2014,(33):4457-4459,3.基金项目
重庆市科技攻关计划项目（cstc2012gg-yyjs10058）；国家临床重点专科建设经费［财社（2011）170号］。 （）
