控制性低中心静脉压在高龄腹腔镜肝切除术中的应用

Application of controlled low central venous pressure in elderly patients undergoing laparoscopic hepatectomy

目的探讨控制性低中心静脉压在高龄腹腔镜肝切除患者中的安全性及应用价值。方法回顾性分析中国科学技术大学附属第一医院自2018年12月至2021年2月收治的45例60岁以上因原发性肝癌行腹腔镜肝切除的患者临床资料。其中采用控制性低中心静脉压(Low central venous pressure,LCVP)28例,正常中心静脉压(Normal central venous pressure,NCVP)组17例。观察比较两组肝切除时间、肝门阻断时间、术中出血量、术后肝肾功能恢复情况、并发症等指标。结果LCVP和NCAP组相比,在切肝时间、肝门阻断时间、总术中出血量、术后早期肝功能恢复等方面差异均有显著性(P<0.05)。在术后并发症上无明显差异(P>0.05)。结论对于高龄患者在腹腔镜切除中应用LCVP是安全有效的,其在减少切肝时间、肝门阻断时间、总术中出血量、术后早期肝功能恢复等方面体现了优势,并未增加心脑血管意外、肾功能障碍等术后并发症。

Objective To explore the safety and efficacy of controlled low central venous pressure in elderly patients undergoing laparoscopic hepatectomy.Methods Clinical data of 45 patients over 60 years old with primary liver cancer who underwent laparoscopic hepatectomy in the First Affiliated Hospital of University of Science and Technology of China from Dec.2018 to Feb.2021 were retrospectively analyzed.Among them,28 cases were treated with low central venous pressure(LCVP),and the rest 17 cases with normal central venous pressure(NCVP).Total liver resection time,Pringle Maneuvre time,intraoperative blood loss,postoperative liver and kidney function recovery,complications and other indicators were observed and compared between the two groups.Results Compared with the NVP group,the patients in LCVP group had significant differences in terms of liver resection time,Pringle Manoeuvre time,intraoperative blood loss,and early postoperative liver function recovery(P<0.05).There was no significant difference in postoperative complications(P>0.05).Conclusion It is safe and effective for elderly patients to apply LCVP into laparoscopic resection,which has advantages in reducing liver resection time,Pringle Maneuvre time,intraoperative blood loss,and early recovery of postoperative liver function without increased postoperative complications.