急性等容性血液稀释联合控制性低中心静脉压对肝叶切除术患者脑氧代谢的影响

Effect of acute normovolemic hemodilution combined with controlled low central venous pressure on cerebral oxygen metabolism of patients with hepalobectomy.

作者信息

Guo Jian-Rong, Shen Hua-Chun, Liu Yang, Xu Feng, Zhang Yi-Wei, Zhang Jian-Ping, Yang Da-Wei

出版信息

Hepatogastroenterology. 2014 Nov-Dec;61(136):2321-5.

Abstract

BACKGROUND/AIMS: The effect of acute normovolemic hemodilution (ANH) combined with controlled low central venous pressure (LCVP) on the cerebral oxygen metabolism of patients with hepalobectomy.

METHODOLOGY

Undergoing hepatic resection operation in 60 cases, were randomly divided into control group, LCVP group (Group II) and ANH + LCVP group (Group IIl). Before hemodilution (T1), decrease of CVP (T2) and increase of CVP (T3) and at the end of surgery (T4), the blood was sampled via the jugular vein bulb and radial artery for blood gas analysis.

RESULTS

Compared with group I, the CaO2 of group II at T3 and T4 was increased; in group III, CaO2 and Da-jvO2 at T2 and T3 were decreased, CjvO2 at T2 decreased, and CaO2 and CjvO2 at T4 increased. Compared with group II, CaO2, CjvO2 and Da-jvO2 of group III at T2 and T3 were decreased. CERO2 of the three groups at T3 and T4 were all decreased (P<0.05 or 0.01). The jugular venous oxygen saturation (SjvO2) and VADL of the three groups at each time point were all within the normal range.

CONCLUSION

The moderate ANH combined with LCVP had no adverse effect on the cerebral oxygen metabolism of the patients with the hepalobectomy.

摘要

背景/目的：急性等容血液稀释（ANH）联合控制性低中心静脉压（LCVP）对肝切除患者脑氧代谢的影响。

方法

60例行肝切除手术患者，随机分为对照组、LCVP组（Ⅱ组）和ANH+LCVP组（Ⅲ组）。在血液稀释前（T1）、CVP降低时（T2）、CVP升高时（T3）及手术结束时（T4），经颈静脉球部和桡动脉采血进行血气分析。

结果

与Ⅰ组比较，Ⅱ组T3、T4时CaO2升高；Ⅲ组T2、T3时CaO2和Da-jvO2降低，T2时CjvO2降低，T4时CaO2和CjvO2升高。与Ⅱ组比较，Ⅲ组T2、T3时CaO2、CjvO2和Da-jvO2降低。三组T3、T4时CERO2均降低（P<0.05或0.01）。三组各时间点颈静脉血氧饱和度（SjvO2）及VADL均在正常范围内。