Value of controlling low central venous pressure in variceal bleeding due to cirrhosis of liver

Objective: To explore the relation between central venous pressure(CVP) and portal venous flow in hepatocirrhosis variceal bleeding,and to study the clinical significance of controlling low central venous pressure.Methods: Fifty-nine patients who had suffered from hepatocirrhosis variceal bleeding and survived were analyzed retrospectively.CVP was dynamically monitored during the treatment.The inner diameter of vena portalis hepatis and the change of the hemodynamics of portal system were detected by color ultrasonagraphy;the liver,renal function and blood lactic acid were monitored.The changes of the inner diameter of vena portalis hepatis,the changes of blood flow rate,the damage of the liver,renal function and the percentage of secondary bleeding were compared.Results: CVP had positive correlation with the inner diameter of vena portalis hepatic.The rate of secondary bleeding was 25.0%in the group controlling low CVP(4-6 cmH₂O) and 64.7% in group I without controlling low CVP(>6-12 cmH₂O) and 63.6% in the group Ⅱ without controlling low CVP(>12 cmH₂O) within 24 hours.The difference was distinct(P<0.05) between the group with controlling CVP and the two groups without controlling CVP.The damage of liver,renal function and lactic acid were not significantly different among the three groups(P>0.05).Conclusions: The changes of central venous pressure during hepatocirrhosis variceal bleeding may indirectly display the hemodynamics of portal system.Dynamical monitoring of CVP and controlling low CVP within 4-6 cmH₂O may decrease the incidence rates of secondary bleeding and dysfunction of organs.