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Lingnan Modern Clinics in Surgery ›› 2017, Vol. 17 ›› Issue (02): 150-154.DOI: 10.3969/j.issn.1009-976X.2017.02.004

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An investigation of volume administration guided by stroke volume variation in hepatolobectomy

WENG Hanqin,CHEN Xiaohong,HAN Qi,SUN Hongwu.   

  • Contact: SUN Hongwu

每搏变异度指导肝叶切除术容量管理的临床研究

翁汉钦 陈笑红 韩琪 孙宏武   

  1. 东莞市人民医院
  • 通讯作者: 孙宏武
  • 基金资助:

    东莞市科技计划医疗卫生项目

Abstract:

Objective To investigate the effect of stroke volume variation SVVas an index of volume administration in hepatolobectomy. Methods Sixty patients undergoing hepatolobectomy were assigned to two groupsthe observation groupGroup SCVP weas maintained at 0-5 cm H2O and SVV maintained at 10±2%and the control group Group C CVP was maintained at 0-5 cm H2O. The hemodynamics of two groups of patients were recorded at certain time points including the 30 minutes after anesthesiaT1the end time of hepatectomyT2and the end time of operationT3. The hemo? globin Hbblood cell volume HCTcreatinine Cr and urea nitrogen Bun levels of the two groups were recorded the day before the operationAthe first day after hepatectomyBand the day after the operationC. The operation timeamount of bleeding and urinethe recovery time of gastrointes? tinal functionthe length of hospital stay and the incidence rate of complications of the two groups were recorded. Results There were no significant differences in genderagebody weight and liver function between the two groups. The comparison of blood flow dynamics of the two groups of patients at T1 T2 and T3 had no statistically significant difference in Group S patients. There was no significant difference in  invasive blood pressureABPand central venous pressureCVPin Group C patientthere was significant difference in cardiac outputCOand heart rateHRT2T3 and T1 comparisonsP<0.05. There was no significant difference in the preoperative and postoperative laboratory indexes of Group SP>0.05. There was no significant difference in the level of urea nitrogenP>0.05);there was significant difference in hemoglobinblood cell pressure and creatinine levels in Group C patientsP<0.05. The clinical data of the two groups showed little change in urine volumethe liver cutting timeblood lossintraoperative fluidgastrointestinal recovery timehospitalization time and complications showed significant difference in the incidence rateP<0.05. Conclusion Liver resection operation under SVV dynamic guidance capacity management is conducive to the control of intraoperative bleeding and reduction blood loss shortens the operation timeoptimizes the individualized rehydration.

Key words: volume management, stroke volume variation, precise hepatectomy

摘要:

目的 探讨每搏变异SVV在肝叶切除术中指导容量管理的可行性。方法 收集我院2015620166月行肝叶切除术患者60分为观察CVP维持在0~5 cmH2OSVV维持102%对照CVP维持0~5 cmH2O。记录两组病人各时间段的血动力学情况包括麻醉30 minT1肝叶切除结束时T2手术结束即T3。记录两组人术前一A肝叶切除结束B和术后第一C的血红蛋Hb血细胞压HCTCr和尿素BUN水平。记录两组病人的手术切肝时间术中出血量尿量术后胃肠道能恢复时间住院天数和并发症发生率。结果 两组患者性别年龄体重肝功能分级上差无显著的统计学意P>0.05。两组患者各时间T1T2T3的血流动力学比较观察组患者异均无统计学意义。对照组患者有创血ABP和中心静脉CVP比较差异无显著统计学P>0.05心输出COHRT2T3T1比较差异有统计学意P<0.05。观察组者术前术后各项化验指标比较差异均无统计学意P>0.05。对照组患者比较尿素氮水平异无统计学意P>0.05血红蛋白血细胞压积和肌酐水平比较差异有统计学意P<0.05两组患者临床资料除尿量变化不大其切肝时出血术中补胃肠道恢复时住院天和并发症发生率比较差异有显著统计学意P<0.05结论 肝叶切除术中应SVV动态指容量管理有利于术中控制出血量及减少输血量缩短手术时间对患者进行优化个体化补液

关键词: 每搏变异度, 精准肝叶切除, 容量管理

CLC Number: