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目的报告曲式单一腹主动脉阻断无血切肝术的临床应用体会,探讨术中平均动脉压变化规律。方法 2009年3～6月江西省肿瘤医院肝脏外科采用曲式单一腹主动脉阻断无血切肝术,切除8例不同部位的肝肿瘤。术中监测病人基础血压与阻断前后及撤钳前后各时间点的血压变化,通过术中给药等方法对血压波动进行调控。结果 8例均安全耐受曲式无血切肝术所导致的血压波动;术中切肝平均出血量96(40～200)mL;腹主动脉阻断平均时间12(7～15)min;所有病人术中术后无需输血,且未出现任何相关并发症。结论曲式单一腹主动脉阻断无血切肝术所致的平均动脉压变化,术中用药物等可以安全调控。曲式无血切肝法可获得满意的无血切肝效果;该法安全、简单易行,便于基层推广。
Objective To report the clinical application of a single abdominal aorta occlusion without blood transfusion and to explore the change of mean arterial pressure during operation. Methods From March to June 2009, liver surgery of Jiangxi Tumor Hospital was performed with a single abdominal aorta occluding bloodless liver resection and resection of eight different liver tumors. Intraoperative monitoring of patients with basal blood pressure and before and after occlusion and withdrawal of pliers before and after changes in blood pressure at various time points, intraoperative administration and other methods to regulate blood pressure fluctuations. Results All the 8 patients were safe and tolerant to the blood pressure fluctuation caused by the bloodless hepatic artery occlusion. The average amount of hepatectomy liver bleeding was 96 (40-200) mL during the operation, and the average time for abdominal aortic blockage was 12 (7-15) min. All patients had no postoperative blood transfusions and no complications. Conclusions The mean arterial pressure change caused by the single abdominal aorta occluding bloodless hepatic surgery can be safely regulated with drugs and so on. The bloodless hepatic method can obtain the satisfactory bloodless hepatic effect; the method is safe, simple and easy to promote at the grassroots level.