急性等容血液稀释联合控制性低中心静脉压在高原肝包虫肝叶切除术中的应用

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Abstract Objective To observe the application of acute normovolemic hemodiluti (ANH) combined with controlled low central venous pressure (CLCVP) on plateau liver hydatid excision. Methods A total of 46 patients with hepatic hydatid were selected from Guoluozhou and Jiuzhi People's Hospital of Qinghai Province from May to December 2020 to undergo hepatic lobotomy for hepatic hydatid. They were randomly divided into two groups according to whether ANH+CLCVP was performed. For the ANH+CLCVP(A) group, ANH was performed after general anesthesia, then LCVP was controlled, and CVP was controlled within 0~5 cmH₂O before hilar occlusion, CVP was restored to 8-12 cmH₂O after complete hemostasis; Neither ANH nor CLCVP were performed in group B, whose CVP were maintained at 8-12 cmH₂O.The changes of Hemody—allogeneic blood transfusion in the two groups were recorded. Changes in　renal function of the two groups were recorded before, immediately after and 24 h after surgery. The postoperative recovery of the patients was observed. Results MAP of group A was lower than that of group B, while HR was higher than that of group B at T3 (P<0.05).The amount of intraoperative blood loss, allogeneic transfusion and the number of cases in group B were more than that of group A, group A had earlier anal exhaust and defecation, shorter activity time out of bed, and significantly shorter hospitalization time than that of group B(P<0.05).The renal function of the two groups at each time point was normal and no significant difference was found (P>0.05). Conclusions Acute normovolemic hemodilution combined with controlled low central venous pressure can be safely used for liver lobectomy in patients with hydatid hepatica on plateau, can significantly reduce the amount of allogeneic blood transfusion, and promote postoperative recovery of patients without side effect, which is worthy of clinical reference.

Key words： acute isovolemic hemodilution controlled low central venous pressure blood protection liver lobectomy plateau

Received: 25 May 2022

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	GONG Huaqu
	YANG Lin
	GONG Gu
	ZHUANG Yanbo
	HAN Shengcai

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GONG Huaqu,YANG Lin,GONG Gu等. Application of acute normovolemic hemodilution combined with controlled low central venous pressure in hepatectomy of hydatid hepatis on plateaus[J]. Med. J. Chin. Peop. Armed Poli. Forc., 2022, 33(10): 853-856.

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http://journal08.magtechjournal.com/Jwk_wjyx/EN/ OR http://journal08.magtechjournal.com/Jwk_wjyx/EN/Y2022/V33/I10/853

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