肝移植后早期中心静脉压水平与各器官功能之间的关系
Relationship between central venous pressure and organ function in early period after liver transplantation
目的 探讨经典原位肝移植术后早期不同中心静脉压(central venous pressure,CVP)水平与各器官功能之间的关系.方法 对2013年1月22日至2015年1月12日111例行经典原位肝移植患者的临床资料进行回顾性分析,根据肝移植术后中心静脉压水平将所有受者分为3组,低CVP组(<8mmHg,1mmHg=0.133 kPa),正常CVP组(8~12 mmHg)和高CVP组(>12mmHg),同时根据48 h内CVP下降水平,分为CVP下降至8mmHg以下组(CVPDB8)和CVP未下降至8 mmHg(CVPNDBS)组.结果 低CVP组、正常CVP组及高CVP组在肝移植术后早期总胆红素(TBil)、肌酐(Cr)及乳酸(Lactate)水平比较,差异有统计学意义(P<0.05);肝移植术后48 hCVPDE8组和CVPNNDB8组在术后液体平衡量、机械通气时间及急性肾损伤发生比较,差异有统计学意义(P<0.05).结论 经典原位肝移植术后CVP水平与肝、肾、肺的功能及乳酸水平恢复有关,肝移植术后早期维持较低CVP水平可缩短机械通气时间,降低急性肾损伤的发生率.
更多Objective To investigate the relationship of central venous pressure (CVP) and organ function in early period after orthotopic liver transplantation (OLT).Methods A retrospective study was conducted on 111 patients who underwent OLT.According to the value of mean CVP after OLT,all patients were divided into three groups:low CVP group (CVP<8 rnmHg,1 rnmHg =0.133 kPa),normal CVP group (CVP 8-12 mmHg) and high CVP group (CVP >12 mmHg).Meanwhile,According to whether the CVP dropped below 8 mmHg or not in the past 48h after surgery,all patients were divided into two groups.Results There were significant differences in serum total bilirubin,serum creatinine and serum lactate among low,normal,and high CVP groups (P<0.05).The time of vasoactive agent,fluid balance,time of mechanical ventilation and incidence of acute kidney injury in groups with CVP not dropped below 8 rnmHg were higher than those in groups with CVP dropped below 8 mmHg (P<0.05).Conclusion CVP was associated with liver,kidney,lung function and lactate.Controlling a lower CVP can significantly shorten the time of mechanical ventilation and reduce the incidence of acute kidney injury after OLT.
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