Hypovolemic Phlebotomy Results In Decreased Central Ventral Venous Pressure In Hepatectomy

Objective:To investigate the effect of Hypovolemic phlebotomy on central venous pressure in hepatectomy.Methods:80 peoples of hepatectomy for hepatocellular carcinoma were randomly divided into two groups.After laparotomy,some blood（0.7%of body weight）was slowly released in group H before the liver parenchyma resection.Transfusion was limited and the target range of CVP maintained after bleeding until the liver parenchyma resection was completed,and then the autologous blood was transferred back.No bleeding was performed in group C.Intraoperative CVP,blood loss,operative and anaesthesia related conditions,postoperative important organ functions（liver function,renal function,coagulation function,platelet function）,postoperative hospital complications,intensive care unit stay,hospital day were recorded.Results::The average CVP of group H before bloodletting T2 was 7.67cmH₂O,the average CVP after T3 bloodletting was 5.4 cmH₂O,and CVP（cmH₂O）=2.27 cmH₂O（Train CVP=CVP before bloodletting--CVP after bloodletting）.That is,the CVP decreased by 2.27 cmH2O after bloodletting.CVP at T4 and T5 in group H was significantly lower than that in group C,P<0.01.The estimated blood loss and HBG（HBG difference before and after surgery）in group H were lower than those in group C（P<0.05）.There were no significant differences in intraoperative HR,MAP,length of hospital stay,postoperative complications and important organ functions between the two groups.Conclusion:Hypovolemic phlebotomy can reduce central venous pressure in hepatectomy.It can reduce the estimated blood loss and has no obvious adverse effect on postoperative complications.