肝切除术中低中心静脉压技术应用评价

Evaluation of the technique of controlled low central venous pressure used during hepatectomy

目的观察低中心静脉压对部分肝脏切除术中出血量的控制和肾功能的影响。方法对54例择期行部分肝脏切除术病人随机分为控制性低中心静脉压组(观察组)26例和对照组28例。观察组在肝实质完全离断过程中中心静脉压控制在0～5cmH2O,于部分肝脏切除后恢复正常;对照组中心静脉压维持在6～12cmH2O。结果观察组术中出血量、输血量均低于对照组(P<0.05),术后24h两组病人肾功能变化无明显差异(P>0.05)。结论控制性低中心静脉压技术可减少部分肝脏切除术术中出血量及输血量,且对肾功能无明显影响。

Objective To investigate the effects of controlled low central venous pressure （CLCVP） on blood loss and renal function during partial liver resection. Methods Fifty-eight patients undergoing partial liver resection were randomized into the control group （n=28） and CLCVP group（n=26）. The central venous pressure （CVP） of CLCVP group patients was maintained at 0-5 cmH2O during hepatic parenchymal transection,that of the control group was normal CVP （6-12 cmH2O）. Results The volume of blood loss and amount of transfusion were significantly lower in the CLCVP group than in the control group （P0.05）. There was no marked difference in renal function between the 2 groups（P0.05）. Conclusion CLVCP can reduce the blood loss and the amount of transfusion during partial liver resection and has no influence on renal function.