论文部分内容阅读
目的:观察肝细胞癌合并肝炎肝硬化患者行肝段切除术围术期动脉血乳酸浓度,及肝门阻断、开放后有创血压的变化。方法:选择择期行肝段切除术的肝硬化患者30名,给予全凭静脉麻醉,于手术开始前、第一肝门阻断开放即时、阻断开放后15min,分别采取动脉血化验血乳酸浓度,记录采取动脉血时血压值及开放后血压最低值,设计为自身前后对照,应用CHISS软件进行统计学分析。结果:开放即时与开放后15min动脉血乳酸浓度与术前比较均有明显统计学差异(P<0.05),乳酸浓度与肝门阻断时间呈正相关,开放即时与开放后动脉血乳酸浓度相比无明显统计学差异(P>0.05)。开放后血压下降程度与乳酸浓度无明显相关,与阻断时间无明显相关。肝门阻断前后及开放后15min患者血红蛋白无明显变化(P>0.05)。结论:肝段切除术围术期行第一肝门阻断后血乳酸浓度明显升高,肝脏再灌注期间乳酸未进一步升高,甚至有所降低。开放后血压下降程度与乳酸浓度无明显相关。
OBJECTIVE: To observe the changes of arterial blood lactic acid concentration, hepatic portal blockage and invasive blood pressure after hepatectomy in patients with hepatocellular carcinoma and hepatic cirrhosis. Methods: Thirty patients with hepatic cirrhosis undergoing elective hepatectomy were enrolled in this study. Before the start of surgery, the first hepatic portal was opened immediately and blocked 15 minutes after the open. , Record the arterial blood pressure and blood pressure after opening the lowest value, designed to control their own before and after, using CHISS software for statistical analysis. Results: The arterial blood lactic acid concentration at 15 min after opening was significantly higher than that before operation (P <0.05). The lactic acid concentration was positively correlated with the time of hepatic portal obstruction. Compared with the open lactic acid concentration No significant difference (P> 0.05). No significant correlation was found between the blood pressure drop and lactic acid concentration after opening, and no significant correlation with the blocking time. There was no significant change in hemoglobin before, after and after hepatic portal vein occlusion (P> 0.05). CONCLUSION: After the first hepatectomy, the concentration of blood lactic acid in the hepatic segmentectomy is significantly increased, and the lactic acid does not increase further or even decrease during the hepatic reperfusion. After opening the level of blood pressure and lactate concentration was not significantly correlated.