Application of goal-directed pulse pressure variation combined with low central venous pressure technique in liver surgery

WANG Ping-juan; SHU Jian-wei; JIANG Tao; LI Cha-bing; GAO Kun-kun; WANG Yi-qiao

doi:10.11659/jjssx.07E024151

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Application of goal-directed pulse pressure variation combined with low central venous pressure technique in liver surgery

Clinical Research | 更新时间：2025-09-24

- Application of goal-directed pulse pressure variation combined with low central venous pressure technique in liver surgery
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 34, Issue 9, Pages: 813-816(2025)
- 作者机构：
  
  安徽省第二人民医院麻醉科，安徽合肥 230041
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.07E024151
  CLC： R614
- Received：29 July 2024，
  
  Published：25 September 2025
- 稿件说明：
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汪平娟,舒见威,江涛等.脉压变异率目标导向结合低中心静脉压技术在肝手术中的应用研究[J].局解手术学杂志,2025,34(09):813-816.

WANG Ping-juan,SHU Jian-wei,JIANG Tao,et al.Application of goal-directed pulse pressure variation combined with low central venous pressure technique in liver surgery[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(09):813-816.
汪平娟,舒见威,江涛等.脉压变异率目标导向结合低中心静脉压技术在肝手术中的应用研究[J].局解手术学杂志,2025,34(09):813-816. DOI： 10.11659/jjssx.07E024151.

WANG Ping-juan,SHU Jian-wei,JIANG Tao,et al.Application of goal-directed pulse pressure variation combined with low central venous pressure technique in liver surgery[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(09):813-816. DOI： 10.11659/jjssx.07E024151.

摘要

目的

探讨以脉压变异率（PPV）为目标导向结合低中心静脉压（LCVP）技术的液体管理策略在肝手术中的应用。

方法

纳入2022年1月至2023年12月于我院行肝叶/段切除手术治疗的86例患者，采用随机序列法将其分为2组，常规组患者给予LCVP技术治疗，试验组患者在常规组基础上给予PPV目标导向干预。对2组患者手术指标、血流动力学指标、认知功能、不良反应和胃肠功能恢复情况进行比较。

结果

2组患者手术时间、肝门阻断时间、术后首次排气时间以及术后首次排便时间比较，差异均无统计学意义（

0.05）；但试验组患者术中出血量、术中补液量以及住院时间均小/短于常规组（

0.05）。与T0时间点相比，2组患者T1、T2时间点心率（HR）升高，平均动脉压（MAP）及中心静脉压（CVP）均降低（

0.05）；2组患者T0、T1、T2、T3时间点HR、MAP组间比较，差异均无统计学意义（

0.05）。T1、T2时间点，试验组患者CVP低于常规组（

0.05）；术后1 d，试验组患者简易精神状态评估（MMSE）评分高于常规组（

0.05）；2组患者术后7 d MMSE评分高于术后1 d（

0.05）。试验组患者不良反应总发生率低于常规组（

0.05），且胃肠功能恢复时间短于常规组（

0.05）。

结论

PPV目标导向结合LCVP技术的液体管理策略在肝手术中具有较好的应用效果，可减少患者术中出血量、术中补液量，缩短住院时间，提高血流动力学的稳定性，改善术后认知功能，促进胃肠功能恢复，治疗安全性较高。

Abstract

Objective

To explore the application of goal-directed fluid therapy based on pulse pressure variation rate （PPV） combined with low central venous pressure （LCVP） technique in liver surgery.

Methods

A total of 86 patients who underwent liver lobe/segment resection in our hospital from January 2022 to December 2023 were included，and randomly divided into two groups by random sequence method. Patients in the conventional group were treated with LCVP technique，while patients in the test group were given PPV goal-directed intervention on the basis of the conventional group. The surgical indicators，hemodynamic indicators，cognitive function，adverse reactions and recovery of gastrointestinal function of patients in the two groups were compared.

Results

There was no statistically significant difference in the operation time，Pringle maneuver time，first postoperative exhausting time or first postoperative defecation time of patients between the two groups（

0.05）. However，the intraoperative blood loss，intraoperative fluid infusion volume and hospital stay of patients in the test group were all less/shorter than those in the conventional group （

0.05）. Compared with the time point of T0，patients in the two groups showed increased heart rate （HR） but decreased mean arterial pressure （MAP） and central venous pressure （CVP）at time points of T1 and T2 （

0.05）. There was no statistically significant difference in the HR or MAP of patients between the two groups at time points of T0，T1，T2 and T3 （

0.05）.At time points of T1 and T2，the CVP of patients in the test group was lower than that in the conventional group （

0.05）. One day after operation，the mini-mental state examination （MMSE） score of patients in the test group was higher than that in the conventional group （

0.05）. The MMSE scores 7 days after operation of patients in the two groups were higher than those 1 day after operation （

0.05）. Patients in the test group had a lower total incidence of adverse reactions and a shorter recovery time of gastrointestinal function than those in the conventional group （

0.05）.

Conclusion

The goal-directed fluid therapy based on PPV combined with LCVP technique has a good application effect in liver surgery，which can reduce intraoperative blood loss and fluid infusion volume of patients，shorten hospital stay，increase hemodynamic stability，improve postoperative cognitive dysfunction，and promote the recovery of gastrointestinal function，with a relatively high treatment safety.

关键词

Keywords

references

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