Abstract：Objective: To investigate the safety and effectiveness of the acute non-normalvolemic hemodilution (ANIH) method in laparoscopic hepatectomy. Method: 50 patients were selected for laparoscopic hepatectomy. According to the treatment method, it was divided into the ANIH group and the control group, with the age ranging from 21 to 77 years. The two groups were all operated with low central venous pressure under control, and the number of intraoperative blood loss and allogeneic blood transfusion cases in the two groups were compared. The postoperative hospitalization time, mean arterial pressure, heart rate and liver function before and after surgery were compared. Results: There was no significant difference in the level of CVP, HR and MAP before operation (P > 0.05) in the two groups. The level of CVP and the level of MAP after blood collection in group ANIH were lower than those in the control group (P < 0.05), and there was no significant difference between the two groups at each period of the HR level (P > 0.05). The liver function related indexes of group ANIH and control group before and after operation (AST, ALT, ALB, TBIL), there was no significant difference between the two groups before operation (P>0.05). The liver function indexes were improved after the operation, and the difference was statistically significant (P < 0.05) before and after operation (P < 0.05). The liver function index of ANIH group was improved compared with the control group. The situation was better. The bleeding volume in group ANIH was lower than that in the control group (P < 0.05), and there was no significant difference in the number of allogeneic blood samples (P>0.05). The recovery time of gastrointestinal tract in group ANIH was significantly lower than that in control group (P < 0.05), and there was no significant difference in hospitalization time between the two groups (P>0.05). Conclusion: The application of acute non-isovolemic hemodilution in laparoscopic hepatectomy is helpful to control low central venous pressure, reduce the chance of bleeding and transfusion of allogeneic blood, and is safe and reliable for patients during perioperative period.
[1] 陈献文.急性非等容血液稀释自储血回输技术的临床应用[J].北方药学,2015(8):191~192. [2] 宣加芳,史美芳.急性非等容性血液稀释法的操作与护理[J].上海护理,2002,2(3):19~21. [3] 李红霞.血液稀释法治疗78例急诊手术患者的临床研究[J].现代诊断与治疗,2014,16(3):645~646. [4] 张岳农,罗荣,邓靖单,等.控制性低中心静脉压技术在腹腔镜肝切除术中的临床应用[J].岭南现代临床外科,2017,17(4):423~427. [5] 王军保.腹腔镜下精准肝切除临床应用价值分析[J].浙江中西医结合杂志,2017(7):598~601. [6] 秦学良,徐钧,底卫东,等.腹腔镜治疗肝血管瘤手术方式选择及疗效的比较分析[J]中华腔镜外科杂志,2014,7(5):350~353. [7] 苏永俊,郭建荣,金孝岠.不同程度急性等容血液稀释对老年脊柱手术患者术后早期认知功能的影响[J].中国老年学杂志,2017,3(37):1447~1450. [8] Knowles S A, Bertens K A, Croome K P, et al. The current role of intraoperative ultrasound during the resection of colorectal liver metastases:A retrospective cohort study[J]. Int Surg,2015,20:101~106.
2018, Vol. 24 
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