关键词: 腹腔镜, 肝切除术, 经食管超声心动图, 中心静脉压, 气栓, 脑损伤

Abstract:

Objective To investigate the development of air thrombolysis and the possible risk of

brain injury in laparoscopic hepatectomy. Methods 80 patients with selected laparoscopic hepatectomy

from Meizhou People's Hospital from April 2018 to January 2021, randomly divided into low central

venous pressure group (L group) and normal central venous pressure group (N group) and 40 each.

Gas incidence, bubble grade and duration were examined by esophageal echocardiography in both

groups which were compared in two groups; Postoperative neurological complications, postoperative

hospitalization, S100B protein and neuron-specific enolase (NSE) levels in preoperative and

postoperative venous blood were compared in two groups. Results Eventually included 66 patients, 35 in

the L group and 31 in the N group. The intraoperative duration of air bubbles in the L group was longer

than in the N group (P ＜ 0.05).Both L, N groups had increased postoperative S100B protein compared to preoperative, while postoperative NSE levels were also higher in the L group (P ＜ 0.05). There were

no significant differences in thrombolysis, bubble grade, postoperative neurological complications, time

of hospitalization, S100B protein and NSE levels in preoperative and postoperative venous blood, and

preoperative and postoperative NSE, differences in the N group (P ＞ 0.05). Conclusion In laparoscopic

hepatectomy, the application of low central venous pressure increased the duration of thrombolysis,

especially between the incidence of thrombolysis and the risk of brain injury.

Key words: Laparoscopic, Hepatectomy, Transesophageal echocardiography, Center venous pressure, Air embolus, Brain injury