关键词: 控制性低中心静脉压, 腹腔镜肝切除术, 术中出血量, 手术时间, 肝肾功能, 胆漏

Abstract: Objective To investigate the effect of controlled low central vein pressure on complex laparoscopic hepatectomy. Methods From January 2018 to May 2020, 60 patients with complex laparoscopic hepatectomy were randomly divided into an observation group （n=30） and a control group （n=30）. The observation group was treated by controlled low central venous pressure technique to maintain central venous pressure （CVP） at 1-3 cmH2O and SAP ≥ 90; while the control group was given conventional operation to keep CVP at 6-12 cmH2O. The intraoperative blood loss, operation time, blood gas indicators, liver and kidney functions, and bile leakage complications were compared between the two groups. Results The operation indexes in the observation group were better than those in the control group （P<0.05）. On postoperative day 1, the blood urea nitrogen, serum creatinine, alanine aminotransferase, and total bilirubin in both groups were increased, while the indexes in the observation group were slightly elevated （P<0.05）; there was no difference in pH and SpO2 between the two groups （P>0.05）, while the PaO2 and BE in the observation group were lower, and the HCO^-₃ was higher than those in the control group （P<0.05）. The incidence of bile leakage was lower in the observation group （P<0.05）. Conclusion In patients undergoing complex laparoscopic hepatectomy, the use of controlled low central venous pressure technique can reduce the amount of bleeding and blood transfusion and reduce the incidence of complications, thereby optimize operation effect, greatly improve the safety of liver surgery, and shorten the length of hospital stay, while not produce significant adverse effects on liver and kidney functions.

Key words: controlled low central venous pressure, laparoscopic hepatectomy, intraoperative blood loss, operation time, liver and kidney functions, bile leakage