【摘要】：目的觀察預(yù)注氫化潑尼松對(duì)老年患者關(guān)節(jié)置換術(shù)中骨水泥植入綜合征的影響。方法擇期行人工關(guān)節(jié)置換術(shù)老年患者51例,隨機(jī)均分為三組,每組17例：非骨水泥組患者在行人工關(guān)節(jié)置換術(shù)時(shí)使用非骨水泥型人工關(guān)節(jié)；骨水泥組患者在行人工關(guān)節(jié)置換術(shù)植入骨水泥前未預(yù)先用藥；氫化潑尼松預(yù)處理組在骨水泥準(zhǔn)備時(shí)緩慢靜注氫化潑尼松0.3mg/kg,每組17人。記錄三組患者骨水泥植入前1分鐘(T0),植入時(shí)(T1),植入后1 min(T2),植入后3min(T3),植入后5min(T4),植入后10min(T5),植入后30min(T6)時(shí)的心率、血壓及血氧飽和度變化,同時(shí)記錄急救藥物的使用情況。結(jié)果與T0時(shí)比較,非骨水泥組在T1-T6時(shí)收縮壓降低(P0.05),骨水泥組在T2～T6時(shí)降低(P0.05),氫化潑尼松預(yù)處理組6個(gè)時(shí)間段差異均無統(tǒng)計(jì)學(xué)意義(P0.05)；氫化潑尼松組在T3-T5時(shí)收縮壓陽(yáng)性率低于其他兩組(P0.05)。與T0時(shí)比較,非骨水泥組在T2～T6時(shí)舒張壓降低(P0.05),骨水泥組在T2-T5時(shí)降低(P0.05),氫化潑尼松預(yù)處理組6個(gè)時(shí)間段差異均無統(tǒng)計(jì)學(xué)意義(P0.05);氫化潑尼松組舒張壓陽(yáng)性率低于其他兩組(P0.05)。三組心率、脈氧飽和度差異均無統(tǒng)計(jì)學(xué)意義。氫化潑尼松預(yù)處理組麻黃堿使用率小于其他兩組。結(jié)論在本試驗(yàn)條件下,預(yù)注0.3mg/kg的氫化潑尼松可以降低老年患者行人工關(guān)節(jié)置換術(shù)骨水泥植入綜合征的發(fā)生。
[Abstract]:Objective to observe the effect of preinjection of hydroprednisone on bone cement implantation syndrome in elderly patients undergoing joint replacement. Methods 51 elderly patients undergoing artificial joint replacement were randomly divided into three groups: 17 patients in non-bone cement group were treated with non-bone cement artificial joint replacement, 17 patients in bone cement group were treated with hydroprednisone 0.3 mg 路kg ~ (- 1) intravenously before bone cement implantation, and 17 patients in each group were treated with hydroprednisone 0.3 mg 路kg ~ (- 1) intravenously. The changes of heart rate, blood pressure and blood oxygen saturation of bone cement were recorded 1 minute before implantation (T0), T1 (T1), 1 min (T2), T3 (T3), 5min (T 4), 10min (T5), 30min (T6). At the same time, the use of emergency drugs was recorded. Results compared with T0, the systolic blood pressure of non-bone cement group decreased at T1-T6 (P 0.05), bone cement group decreased at T2~T6 (P 0.05), hydroprednisone pretreatment group had no significant difference in 6 time periods (P 0.05), and the positive rate of systolic blood pressure in hydroprednisone group was lower than that in the other two groups at T3-T5 (P 0.05). Compared with T0, diastolic blood pressure in non-bone cement group decreased at T2~T6 (P 0.05), bone cement group decreased at T2-T5 (P 0.05), hydroprednisone pretreatment group had no significant difference in 6 time periods (P 0.05), and the positive rate of diastolic blood pressure in hydroprednisone group was lower than that in the other two groups (P 0.05). There was no significant difference in heart rate and pulse oxygen saturation among the three groups. The utilization rate of ephedrine in hydroprednisone pretreatment group was lower than that in the other two groups. Conclusion preinjection of hydroprednisone with 0.3mg/kg can reduce the incidence of bone cement implantation syndrome in elderly patients undergoing artificial joint replacement.
【學(xué)位授予單位】：南京大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R687.4

【參考文獻(xiàn)】

相關(guān)期刊論文 前3條

1 師曉琴;彭娜;韓保君;趙雄;汪晨;;骨水泥植入綜合征研究進(jìn)展[J];國(guó)際骨科學(xué)雜志;2009年03期

2 劉尚禮;陳燕濤;;人工髖關(guān)節(jié)置換術(shù)中嚴(yán)重骨水泥反應(yīng)綜合征[J];中國(guó)醫(yī)師進(jìn)修雜志;2006年20期

3 周慶;陳毅飛;何厚沐;唐小平;王靈君;;臂叢加頸叢神經(jīng)阻滯在肩部手術(shù)中的應(yīng)用[J];西南國(guó)防醫(yī)藥;2013年05期

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本文編號(hào)：2509551