CAJ | 학술논문

目的：探讨老年患者肝叶切除手术中使用控制性低中心静脉压技术（LCVP）对患者脑氧代谢的影响。方法：择期行肝叶切除的A S AⅠ～Ⅱ级老年患者40例，随机分为两组：L组为实验组：肝实质离断期间维持CV P在2～3cm H2 O ，离断后使中心静脉压恢复到正常水平。C组为正常输液组（对照组），维持中心静脉压6～12cmH2 O。两组于肝实质离断前（T1），肝实质离断后升压前（T2）和离断后30min （T3）同步采集桡动脉和颈内静脉血行血气分析，并计算动脉血氧含量（CaO2）、颈内静脉球部血氧含量（CjvO2）、动脉-颈内静脉血氧含量差（Da-jvO2）、脑氧摄取率（CE-RO2）、动静脉血乳酸浓度差（LACjv-a）和动静脉血糖浓度差（GLUjv-a）。结果：两组患者脑氧代谢指标在各时间点比较统计学无差异，每组患者各时间点比较差异无统计学意义。结论：控制性低中心静脉压对老年肝叶切除术患者的脑氧代谢无明显影响。
목적：탐토노년환자간협절제수술중사용공제성저중심정맥압기술（LCVP）대환자뇌양대사적영향。방법：택기행간협절제적A S AⅠ～Ⅱ급노년환자40례，수궤분위량조：L조위실험조：간실질리단기간유지CV P재2～3cm H2 O ，리단후사중심정맥압회복도정상수평。C조위정상수액조（대조조），유지중심정맥압6～12cmH2 O。량조우간실질리단전（T1），간실질리단후승압전（T2）화리단후30min （T3）동보채집뇨동맥화경내정맥혈행혈기분석，병계산동맥혈양함량（CaO2）、경내정맥구부혈양함량（CjvO2）、동맥-경내정맥혈양함량차（Da-jvO2）、뇌양섭취솔（CE-RO2）、동정맥혈유산농도차（LACjv-a）화동정맥혈당농도차（GLUjv-a）。결과：량조환자뇌양대사지표재각시간점비교통계학무차이，매조환자각시간점비교차이무통계학의의。결론：공제성저중심정맥압대노년간협절제술환자적뇌양대사무명현영향。
Objective:To discuss the influence on cerebral metabolism in the elderly under low central ve-nous pressure .Method:40 ASA class Ⅰ ~ Ⅱold patients with elective liver resection were randomly divided into L group and C group .In the LCVP group ,CVP was maintained 2~3cmH2 O during liver resection .The patients in the control group received standard care .At hepatic parenchymal transection before (T1) ,hepatic parenchyma after transecting boost before (T2) and 30min (T3) severed ,synchronous radial artery and internal jugular vein blood gas analysis were collected and were calculated the CaO 2 ,CjvO2 ,Da-jvO2 ,CERO2 ,LACjv-a and GLUjv-a .Rusults :There was no statistical difference in cerebral oxygen metabolism indicators at each time point between two groups . There was no significant difference at each time point in single group .Conclusion :There is no influence on cerebral oxygen metabolism in the elderly under Hepatic Resections with low central venous pressure .