Clinical Effect of Detection and Correction of Left Ventricular Ejection Time Combined with Dobutamine in Intraoperative Management of Patients with Hepatectomy
Objective To evaluate the clinical effect of correction of left ventricular ejection time combined with dobutamine in intraoperative management of patients undergoing hepatectomy.Methods A total of 68 patients undergoing elective hepatectomy for liver cancer in Cangzhou Central Hospital from May to November 2022 were selected and divided into esophageal ultrasound group(group S)and esophageal ultrasound combined with dobutamine group(group D)by random number table method,with 34 patients in each group.In group S,nitroglycerin was pumped intravenously from the beginning of the operation to the completion of hemostasis after partial hepatectomy.In group D,dobutamine was pumped continuously from the beginning of the operation to the completion of hemostasis after partial hepatectomy,and nitroglycerin was pumped.CVP,HR,MAP[at the time of entering operation room(T0),immediately after induction(T1),at the beginning of operation(T2),at the time of hepatic portal occlusion(T3),after partial hepatectomy(T4)and at the end of operation(T5)],SV,LVETc at T1-T5 were compared.Oxygen delivery index(DO21)and estimated oxygen extraction rate(O2ERe)at T0 and T5,as well as postoperative adverse events were recorded.Results Finally,64 patients were included.Compared with group S,the CVP value was decreased at T2-T3,the SV value was increased at T2-T5,the intraoperative blood loss was decreased,the intraoperative urine volume was significantly increased,the total dose of nitroglycerin was decreased,the incidence of intraoperative hypotension was decreased,and the incidence of intraoperative cardiac gas embolism was decreased in group D(P＜0.05).Conclusion Esophageal ultrasound detection of LVETc combined with dobutamine can ensure hemodynamic stability in patients undergoing partial hepatectomy,and reduce the incidence of intraoperative hypotension and air embolism.
Primary liver cancerCorrected left ventricular ejection timeDobutamineControlled low central venous pressureLiver tumor
万方数据
维普
