静脉-静脉转流下原位肝移植术无肝早期及新肝早期的循环变化及处理

Hemodynamic Changes and Treatments of Early Anhepatic and Reperfusion Phase during Liver Transplantation with Veno-Venous Bypass

目的 :探讨静脉转流下原位肝移植无肝早期和新肝早期的循环变化和处理。方法 :2 1例终末肝病病人接受肝移植手术 ,无肝期采用体外静脉 静脉转流 ,观察无肝早期和新肝早期不同时间点的BP、HR、CO、CI和CVP值。结果 :BP在无肝早期和新肝早期均降低 ,但新肝早期降低更多 ,出现时间更早 ;CO、CI和CVP在无肝早期降低 ,在新肝早期增高。HR各期变化不大。结论 :体外静脉转流下原位肝移植无肝早期和新肝早期的循环均有改变 ,主要通过适量快速泵注全血纠正。

Objective:To investigate hemodynamic changes and treatments of early anhepatic phase and early reperfusion phase during liver transplantation with veno-venous bypass.Methods:21 end-stage liver disease patients received liver transplantation.Veno-venous bypass was performed during anhepatic phase. BP,HR,CO,CI and CVP were measured at different time points of early anhepatic phase and early reperfusion phase.Results:BP decreased during both phases ( P< 0 05),which happened more and earlier in the early reperfusion phase.CO,CI and CVP were decreased during early anhepatic phase and increased during early reperfusion phase( P< 0 05).There were no obvious changes of HR,in two phases.Conclusions:Hemodynamic changes may occur during early anhepatic phase and early reperfusion phaes.Blood infusion with pump is a main effective treatment