Experimental And Clinical Research On The Correlation Between Central Venous Pressure And Portal Pressure

OBJECTIVE:To study the correlation between central venous pressure(CVP)and portal venous pressure(PVP)in Bama minipigs and their cirrhosis models.MATERIALS AND METHODS:(1)Six healthy Bama miniature pigs were randomly divided into Group N and Group C.(2)Pigs in Group N were fed standard.Pigs in Group C were given Carbon Tetrachloride Tetrachloromethane(CCL4)by intraperitoneal injection and oral feeding.(3)Liver function and Doppler ultrasound were usedto exam thepigs,and confirm pigs with cirrhosis.(4)Anesthesisedthe pigs and established CVP and PVPmeasurement pathways,adjust the CVP at different levels,test the corresponding PVP,analysis of the correlation between the two.RESULTS:(1)A pig in Goup C was died due to intraperitoneal injection,5pigs in both groupswere used duringthe next experiment.(2)CVP and PVP were linearly correlated(P <0.05),and the correlation coefficient was 0.75 in Group N.There was no linear correlation between CVP and PVP in group C(P>0.05).(3)All animals were successfully completed the experiment,there wereno surgery and anesthesia-related serious complications.CONCLUSION:CVP and PVP were positively correlated in normal Bamaminiature pigs with a correlation coefficient of 0.75,which was not in the cirrhosis model pigs.OBJECTIVE:To explore the effect of controlled low Venouse pressure(CLCVP)on hepatectomyin patients with hepatocellular carcinoma(HCC).(2)To study the correlation of CVP and PVP in patients with HCC.MATERIALS AND METHODS:(1)Forty-five patients with HCC who underwent hepatectomy were selected from the Affiliated Tumor Hospital of Guangxi Medical University.Aged between 18 and 75 years old,ASAI ~ II.(2)Patients were randomly divided into three groups of A,B,C,15 cases each.CVP was controlled at 3-4 cm H2 O until finished remove of the cancer in Group A.Similarly,CVP was 5-6cm H2 O in Group B and 7-8cm H2 O in Group C.Heart rate,mean arterial pressure were measured at each time point.Finished of portal vein catheterization(T1),CVP was reached(T2),before hilar block(T3)and off-(T5).Operation time and resuscitation time were recorded at the end of the operation(T5).The patients were admitted to the ICU(T6)after operation.Red blood cell(RBC),hemoglobin(HB),prothrombin time(PT),activated partial thromboplastic time(APTT),thrombin time(TT),total bilirubin(T.BIL),direct bilirubin(D.BIL),indirect bilirubin(I.BIL)and the general information and postoperative pathological results were recored.RESULTS:(1)There was no significant difference in sex,age and bodyweight between groups(P> 0.05).Tumor volume and liver resection volume in Group B was higher than group A and group C,but there was no significant difference(P> 0.05).The operation time was significantly higher in group B than in group A and group C(P> 0.05).Compared with group A,CVP was significant difference between group B and group C at T2-T4(P <0.05).There was no significant difference between groups in PVP,MAP and HR(P> 0.05).There was no significant difference in RBC,HB,PT,APTT,TT,T.BIL,D.BIL and I.BILbetween groups(P> 0.05).CVP and PVP were significantly correlated in Patients with HCC and patients with HCC and without cirrhosis(P <0.05),the correlation coefficient was 0.43 and 0.63.There was no linear correlation between CVP and PVP in patients with HCC and cirrhosis(P> 0.05).CONCLUSION:CLCVP can reduce the bleeding volume in hepatectomy,but the tumor volume has greater impact on bleeding.(2)CLCVP had no impact on postoperative RBC,HB,liver function and coagulation function.(3)CVP is closely related to PVP in patients of HCC without liver cirrhosis related to the overall group,and is not related in patients with HCC and cirrhosis..