To investigate the clinical study of perioperative volume management based on inferior vena cava distensibility (dIVC) in laparoscopic partial hepatectomy.

A total of 64 patients who underwent laparoscopic hepatectomy in Cangzhou Hospital of Integrated Traditional Chinese Medicine and Western Medicine from July 2019 to March 2021 were selected and divided into dIVC group (following vena cava variation as guideline) and CVP group (following central venous pressure as guideline) according to the random number table method, with 32 cases in each group. The changes of mean arterial pressure (MAP), blood oxygen saturation (SPO₂), oxygenation index and blood lactic acid were recorded before anesthesia (T0), at the beginning of surgery (T1), at the end of surgery (T2) and 6 h after operation (T3) in the two groups. Liver and kidney function indexes including alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), creatinine (Cr) and urea nitrogen (BUN) in both groups were recorded before and 1, 3 and 5 days after operation. Postoperative ventilation time, recovery time and dosage of propofol were recorded.

MAP (t=2.427, 2.872, 3.826, P=0.018, 0.006, <0.001), SPO₂ (t=2.454, 2.129, 2.661, P=0.017, 0.037, 0.010) and oxygenation index (t=2.961, 2.095, 2.946, P=0.004, 0.040, 0.005) of dIVC group from T1 to T3 were higher than those of CVP group, with statistical significances. The blood lactic acid level of dIVC group at T2 and T3 was lower than that of CVP group, with statistical significances (t=2.263, 7.845, P=0.027, <0.001). The serum level of ALT (t=2.766, 2.991, P=0.008, 0.004) of dIVC group was lower than that of CVP group on day 3 and 7 after surgery, AST (t=2.894, 2.482, P=0.005, 0.016) of dIVC group was lower than that of CVP group on day 1 and 3 after surgery, and TBIL (t=2.236, P=0.029) level of dIVC group was lower than that of CVP group on day 3 after surgery, with statistical significances. There were no significant differences in the levels of Cr (t=0.560, 0.259, 0.098, P=0.578, 0.796, 0.922) and BUN (t=0.222, 0.362, 0.569, P=0.825, 0.718, 0.572) between the two groups after operation. The duration of intraoperative mechanical ventilation and recovery time of dIVC group were both shorter than those of CVP group, with statistically significant differences (t=2.828, 2.599, P=0.006, 0.012), while there were no statistically significant differences in intraoperative propofol dosage, operation time and intraoperative blood transfusion between the two groups (t=1.928, 0.417, 0.110, P=0.058, 0.678, 0.740).

Volume management based on variation of dIVC can maintain hemodynamic stability, improve microcirculation perfusion, improve tissue oxygen supply and reduce liver function injury.