广西医学2016，Vol.38Issue(7)：937-940,4.DOI:10.11675/j.issn.0253-4304.2016.07.13
控制性低中心静脉压对肝叶切除术患者血流动力学及心肌损伤的影响
Effect of controlled low central venous pressure on hemodynamics and myocardial injury in patients undergoing hepatic lobectomy
摘要
Abstract
Objective To explore the effect of controlled low central venous pressure (LCVP) on hemodynamics and myocardial injury in patients undergoing hepatic lobectomy .Methods Forty patients planned to receive hepatic lobectomy were randomly divided into controlled LCVP group(Group L,n=20) and control group(Group N,n=20).In Group L,controlled LCVP was performed,the speed of liquid infusion was controlled strictly,and central venous pressure(CVP) maintained from 0 to 5 cmH2O during operation.In Group N,the traditional liquid administration was performed ,and CVP maintained from 6 to 12 cmH2O(the normal).At one minute before anesthesia, one minute before hepatic lobectomy ,one minute after hepatic lobectomy ,and one minute after operation ,the hemodynamic changes ,the intraoperative blood loss,and the volumes of blood transfusion and fluid transfusion were recorded in the two groups .The levels of serum creatine kinase isoenzyme MB(CK-MB) and cardiac troponin I(cTnI) were detected before operation,one minute before operation,and one minute,12 hours and 24 hours after operation .Results There were no statistical differences in the systolic blood pressure ,diastolic blood pressure,mean arterial pressure or heart rate between two groups (P>0.05).The intraopeartive blood loss,the volumes of blood transfusion and liquid infusion in Group L were significantly less those in Group L (P<0.05).There were no statistical differences in the level of CK-MB or level of cTnI between two groups (P>0.05).Conclusion Controlled LCVP can reduce the intraopeartive blood loss , the volumes of blood transfusion and liquid infusion significantly ,has no obvious effect on hemodynamics in the patients undergoing hepatic lobectomy ,and probably does not cause the myocardial injury .关键词
肝脏切除术/控制性低中心静脉压/血流动力学/心肌肌钙蛋白I/肌酸激酶同工酶MBKey words
Hepatic lobectomy/Controlled low central venous pressure/Hemodynamics/Cardiac Troponin I/Creatine kinase isoenzyme MB分类
医药卫生引用本文复制引用
梁大顺,廖历兴,阮骆阳,吴国忠,李敏,陈文江..控制性低中心静脉压对肝叶切除术患者血流动力学及心肌损伤的影响[J].广西医学,2016,38(7):937-940,4.基金项目
广东省湛江市科技计划项目 （）
