急性高容血液稀释联合低中心静脉压在肝叶切除术中的应用-外科学专业论文.docxVIP

摘 要 急性高容血液稀释联合低中心静脉压 在肝叶切除术中的应用 摘 要 目的 研究肝叶切除术中应用急性高容血液稀释联合低中心静脉压的可行性和 安全性。方法 60 例限期行肝叶切除术患者，ASAⅠ或Ⅱ级，随机分为 A、B、C 三 组，每组 20 例，A 组为低中心静脉压组(LCVP)，B 组为急性高容血液稀释组(AHHD)， C 组为低中心静脉压联合急性高容血液稀释组(LCVP+AHHD)，分别对三组患者实施 低中心静脉压、急性高容血液稀释及低中心静脉压联合急性高容血液稀释，并连续 监测收缩压、舒张压、平均动脉压、中心静脉压等血流动力学指标，分别于麻醉诱 导后(T0)、肝实质横断前(T1)、肝实质横断后(T2)及手术结束时(T3)采集中心静脉血及 桡动脉血行实验室检查；并比较三组患者术中出血量。结果 出血量 B 组与 A 组、C 组相比较差异有统计学意义；血乳酸、动脉氧分压及凝血功能三组间相比较差异无 统计学意义。结论 低中心静脉压联合急性高容血液稀释应用于肝叶切除术中能够减 少术中出血且对凝血功能及氧供需平衡无影响，低中心静脉压联合急性高容血液稀 释用于肝叶切除术中是安全有效的。 关键词 : 肝叶切除术；低中心静脉压；急性高容血液稀释 - 1 - 新疆医科大学医学硕士学位论文 The application of acutehypervolemic hemodilution combined with low centralvenous pressure in hepatic resection Abstract Objective To investigate the feasibility and safety of the application of acute hypervolemic hemodilution combined with low centralvenous pressure in hepatic resection. Methods sixty patients with ASAⅠ-Ⅱ, scheduled for selective hepatic resection were randomly divided into A, B and C with 20 cases each. Low centralvenous pressure was performed in group A, acute hpervolemic hemodilution was performed in group B, and both technique were performed in group C. Results There is significant difference between B group with A group and C group in blood loss. There is no significant difference in blood 2-hydroxypropionic acid、 PaO2 and blood coagulation between three groups. Conclusion To application low centralvenous pressure combined with acute hypervolemic hemodilution in hepatic resection can reduce blood loose volume and there in no effect in blood coagulation and oxygen supply. To application of acute hypervolemic hemodilution combined with low centralvenous pressure in hepatic resection is safety and effective. Key words: hepatic resection; low centralvenous pressure; acute hypervolemic hemodilution in hepatic resection - 2 - 中英文缩略词对照表 英文缩写 英文全名 中文译名 LCVP Low central venous pressure: 低中心静脉压 SBP Systolic blood pressure 收缩压 DBP Diastolic blood pressure 舒张压 MAP Mean ateria