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控制性低中心静脉压在肝癌切除术中的应用

作者：钟锦秀吴少娟黄康强陈钦寿

单位：广东省高州市人民医院麻醉科广东高州 525200

关键词：低中心静脉压肝癌切除术出血量肝肾功能

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出版年,卷(期):页码：2015,7(4):86-89

摘要：

摘要：目的探讨控制性低中心静脉压在肝癌切除术中的应用效果。方法选取广东省高州市人民医院
24例择期行肝癌切除手术的原发性肝细胞癌患者为研究对象，分为低中心静脉压（low central venous
pressure，LCVP）组和常规中心静脉压（normal central venous pressure，NCVP）组，每组12例。对
两组患者的临床指标进行观察和比较。结果 ①LCVP组患者的失血量、RBC输注量优于NCVP组，
差异显著（t = 4.7012，P = 0.0001）；②两组患者术后24小时的丙氨酸转氨酶和胆红素水平与术前
相比显著升高，差异有统计学意义（t = 16.4277、16.6581、3.9656、4.2264，P = 0.0000、0.0000、
0.0007、0.0003）；两组间术后24小时的丙氨酸转氨酶和胆红素水平差异无统计学意义（t = 0.2796、
0.5276，P = 0.7824、0.6031）。③两组患者术前和术后24小时肾功能差异无统计差异（t = 0.4504、
0.9285、0.2796、0.5276，P = 0.6568、0.3632、0.7824、0.6031）。结论在临床针对肝癌患者实施手
术治疗过程中，采用控制性低中心静脉压可有效减少患者失血量，降低围术期输血带来相关风险，
在一定程度上缓解血源紧张，提高手术安全性，且对患者肝、肾功能无明显影响。

Abstract: Objective To investigate the application of controlled low central venous pressure on hepatic
carcinectom. Methods Total of 24 cases with hepatocellular carcinoma who underwent liver cancer
resection operation were selected as the research objects and were randomly divided into two groups, low
central venous pressure ( LCVP ) group and normal central venous pressure ( NCVP ) group, each group
included 12 cases. The clinical indexes of the two groups were observed and compared. Results ①The
volume of blood loss, RBC infusion of the patients in LCVP group were better than those of the NCVP
group, the difference was statistically significant (t = 4.7012, P = 0.0001).②Alanine aminotransferase and
bilirubin level of the patients 24 hours after operation in both groups were significantly higher than those
of the preoperative level (t = 16.4277, 16.6581, 3.9656, 4.2264, P = 0.0000, 0.0000, 0.0007, 0.0003);
the difference of alanine aminotransferase and bilirubin level 24 hours after operation between the two
groups of the patients had no statistical significance(t = 0.2796, 0.5276, P = 0.7824, 0.6031).③The
preoperative and 24 hours after operation of renal function indexes of the two groups had no statistical
significance (t = 0.4504, 0.9285, 0.2796, 0.5276，P = 0.6568, 0.3632, 0.7824, 0.6031). Conclusions In
hepatic carcinectomy, the blood loss and the relative risk of blood transfusion in perioperative period can
be effectively reduced by controlled low central venous. It can also improve the safety of the operation and
has no obvious effects on the liver and renal function of the patients.

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