Bleeding in Liver Surgery: Prevention and Treatment

被引：73

作者：

Alkozai, Edris M. ^{[1
]}

Lisman, Ton ^{[1
]}

Porte, Robert J. ^{[1
]}

机构：

[1] Univ Groningen, Univ Med Ctr Groningen, Dept Surg, Sect Hepatobiliary Surg & Liver Transplantat, NL-9700 RB Groningen, Netherlands

来源：

CLINICS IN LIVER DISEASE | 2009年 / 13卷 / 01期

关键词：

Blood loss; Liver transplantation; Liver resection; Surgical methods; Central venous pressure; Fibrin sealants; Aprotinin; Tranexamic acid; CENTRAL VENOUS-PRESSURE; RECOMBINANT FACTOR VIIA; REDUCES BLOOD-LOSS; TRANSFUSION REQUIREMENTS; VASCULAR OCCLUSION; CELL TRANSFUSION; TRANEXAMIC ACID; TRANSPLANTATION; RESECTION; COAGULATION;

D O I：

10.1016/j.cld.2008.09.012

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Intraoperative blood loss and transfusion of blood products are negatively associated with postoperative outcome after liver surgery. Blood loss can be minimized by surgical methods, including vascular clamping techniques, the use of dissection devices, and the use of topical hemostatic agents. Preoperative correction of coagulation tests with blood products has not been shown to reduce intraoperative bleeding and it may, in fact, enhance the bleeding risk. Maintaining a low central venous pressure has been shown to be effective in reducing blood loss during partial liver resections, and volume contraction rather than prophylactic transfusion blood products seems justified in patients undergoing major liver surgery. Although antifibrinolytic drugs have proved to be effective in reducing blood loss during liver transplantation, systemic hemostatic drugs are of limited value in reducing blood loss in patients undergoing partial liver resections.

引用

页码：145 / +

页数：12

共 59 条

[21] Aprotinin reduces blood loss in patients undergoing elective liver resection [J].