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目的 探讨每搏变异度(SVV)与维持低中心静脉压(CVP)对肝叶切除术患者血乳酸水平和术后肝肾功能的影响.方法 60例肝叶切除术患者随机均分为SVV组和低CVP组.低CVP组患者维持CVP在5cmH2O以下,SVV组在其基础上通过输注6%羟乙基淀粉使SVV低于12%.比较两组术中低血压发生次数、去氧肾上腺素使用量、出血量、输液量、输血量、血乳酸水平以及术后血清胆红素、白蛋白和血尿素氮的水平.结果 SVV组患者的输液量、低血压发生次数和去氧肾上腺素使用量均少于低CVP组[(2858.67±416.91)ml vs.(3324.89±542.96)ml、(5.96±1.67)次vs.(10.62±2.14)次和(264.39±29.56)μg vs.(439.51±43.82)μg](P<0.05).两组患者切皮4h后和手术结束时的血乳酸水平均高于术前(P<0.05),SVV组均低于低CVP组(P<0.05).两组患者术后血清白蛋白水平均较术前降低(P<0.05),SVV组高于低CVP组(P0.05).结论 控制SVV与维持低CVP能减少肝叶切除术患者术中低血压发生、降低血管活性药物用量和患者血乳酸浓度,避免术后低蛋白血症的发生.“,”Objective To study the effects of stroke volume variation(SVV) and low central venous pressure(CVP) on blood lactate level and postoperative liver and kidney function in the patients undergoing hepatolobectomy.Methods Sixty patients undergoing hepatolobectomy were randomly and equally divided into two groups.CVP was maintained less than 5cmH2O in group LC,and group SVV was given additional intravenous infusion of 6% hydroxyethyl starch to control SVV less than 12%.The incidence of hypotension,usage of phenylephrine,blood loss,blood transfusion,blood lactate level during operation and serum levels of bilirubin,albumin and blood urea nitrogen after operation were compared between two groups.Results Transfusion volume,the incidence of hypotension and phenylephrine use were less in group SVV than those in group LC[(2858.67±416.91)ml vs.(3324.89±542.96)ml,(5.96±1.67)times vs.(10.62±2.14)times and (264.39±29.56)μg vs.(439.51±43.82)μg](P<0.05).The blood lactate level was higher at four hours after skin incision and at the end of operation than that before in two groups,which was lower in group SVV than that in group LC(P<0.05).Serum albumin level was lower after operation than that before in two groups,which was higher in group SVV than that in group LC(P0.05).Conclusion Controlling SVV and keeping lower CVP can significantly reduce the occurrence of hypotension and use of vasoactive agents,and avoid postoperative hypoalbuminemia in the patients undergoing hepatolobectomy.