摘要
AIM： To investigate the effect of low central venous pressure （LCVP） on blood loss during hepatectomy for hepatocellular carcinoma （HCC）. METHODS： By the method of sealed envelope, 50 HCC patients were randomized into LCVP group （n=25） and control group （n=25）. In LCVP group, CVP was maintained at 2-4 mmHg and systolic blood pressure （SBP） above 90 mmHg by manipulation of the patient＇s posture and administration of drugs during hepatectomy, while in control group hepatectomy was performed routinely without lowering CVP. The patients＇ preoperative conditions, volume of blood loss during hepatectomy, volume of blood transfusion, length of hospital stay, changes in hepatic and renal functions were compared between the two groups. RESULTS： There were no significant differences in patients＇ preoperative conditions, maximal tumor dimension, pattern of hepatectomy, duration of vascular occlusion, operation time, weight of resected liver tissues, incidence of post-operative complications, hepatic and renal functions between the two groups. LCVP group had a markedly lower volume of total intraoperative blood loss and blood loss during hepatectomy than the control group, being 903.9 ± 180.8 mL vs 2 329.4 ±2 538.4 （W=495.5, P〈0.01） and 672.4±429.9 mL vs 1 662.6±1 932.1 （W=543.5, P〈0.01）. There were no remarkable differences in the pre-resection and post-resection blood losses between the two groups. The length of hospital stay was significantly shortened in LCVP group as compared with the control group, being 16.3±6.8 d vs 21.5 ± 8.6 d （W= 532.5, P〈0.05）.CONCLUSION： LCVP is easily achievable in technique. Maintenance of CVP ≤4 mmHg can help reduce blood loss during hepatectomy, shorten the length of hospital stay, and has no detrimental effects on hepatic or renal function.
瞄准：为肝细胞癌(HCC ) 在肝切除术期间在失血上调查低中央静脉压(LCVP ) 的效果。方法：由封上的信封的方法， 50 个 HCC 病人被使随机化进 LCVP 组(n=25 ) 和控制组(n=25 ) 。在 LCVP 组， CVP 被病人的姿势的操作和药的管理在肝切除术期间在 90 毫米汞柱上面在 2-4 毫米汞柱和收缩血压(SBP ) 维持，当没有阴沉的 CVP，在控制组肝切除术习惯性地被执行时。病人的外科手术前的条件，失血的体积在肝切除术期间，输血的体积，一些医院停留，在肝、肾的功能的变化在二个组之间被比较。结果：处于病人的外科手术前的条件没有有效差量，最大的肿瘤尺寸，肝切除术的模式，脉管的吸藏的持续时间，手术时间， resected 肝纸巾的重量，手术后的复杂并发症的发生，在二个组之间的肝、肾的功能。LCVP 组比控制组在肝切除术期间有全部的 intraoperative 失血和失血的显著地更低的体积，是 903.9+/-180.8 mL 对 2 329.4+/-2 538.4 (W=495.5， P<0.01 ) 并且 672.4+/-429.9 mL 对 1 662.6+/-1 932.1 (W=543.5， P<0.01 ) 。在在二个组之间的切除术前和切除术以后的失血没有显著差别。医院停留的长度显著地作为与控制组相比在 LCVP 组被弄短，是 16.3+/-6.8 d 对 21.5+/-8.6 d (W=532.5， P<0.05 ) 。结论：LCVP 在技术是容易可完成的。CVP<or= 4 毫米汞柱的维护能帮助在肝切除术期间减少失血，弄短医院的长度留下来，并且没在肝或肾的功能上有有害效果。
