低中心静脉压用于减少腹腔镜肝叶切除术中的出血量

目的研究控制性低中心静脉压技术能否减少腹腔镜肝叶切除术中的出血量,并评价此技术对肾功能的影响。方法40例行腹腔镜肝叶切除术的患者,随机分为对照组和低中心静脉压(LCVP)组,采用静吸复合全麻。LCVP组通过切肝前控制输液量和微泵静注硝酸甘油将CVP控制<5mmHg。观察两组病人术中失血量、输血量、切肝前输液量、收缩压和术后24h肾功能的变化。结果LCVP组术中失血量、输血量、切肝前输液量和收缩压均低于对照组(P>0.05);术后24h两组患者肾功能的变化无显著性差异(P>0.05)。结论LCVP可明显减少腹腔镜肝叶切除术中的失血量和输血量,对肾功能无明显影响。

Effects of Lo Central Venous Pressure Decreasing Blood Loss in Lobectomy of Liver Under Ventroscope

Objective To study weather the control lo central venous pressure(CVP) is able to reduce the blood loss or not in lobectomy of liver under ventroscope, and to evaluate effects to renal function. Methods 40 patients receiving lobectomy of liver under ventroscope were randomly divided into control group and lo central venous pressure(LCVP) group. All received venous-inhaled combined general anesthesia. The CVP of LCVP group was controlled lower than 5 mmHg by regulating dose of transfusion before liver resection and injecting nitroglycerin with micro-infusing pump. Data such as blood loss,blood transfusion ,dose of transfusion before liver resection,SBP and variance of renal function 24h after lobectomy were observed. Results Blood loss,blood transfusion,dose of transfusion before liver resection and SBP of patients in LCVP group are all lower than those in control group( P >0.05); and there was no significant difference between two groups in variance of renal function 24h after lobectomy. Conclusion WT LCVP is able to obviously reduce patients' blood loss and blood transfusion in lobectomy of liver under ventroscope and has no significant effects on renal function.