摘要
目的观察髋关节置换术中骨水泥对心肌酶谱和血清肌钙蛋白的影响，同时记录心电图及血流动力学黟变，对心肌损害进行综合评价。方法选择择期行髋关节置换术患者60例，ASAⅠ～Ⅱ级，按术中是否使用骨水泥随机分为两组，Ⅰ组（30例）术中使用骨水泥，Ⅱ组（30例）术中未使用骨水泥。分别于术前（T1）、术后4h（T2）、术后24h（T3）抽静脉血测定心肌酶谱及肌钙蛋白，同时观察心电图和血流动力学变化。结果两组患者的心肌酶谱及肌钙蛋白变化均无统计学意义（P〉0．05），但Ⅰ组患者的肌钙蛋白、CK在T2、T3时刻均高于Ⅱ组，且于T3持续升高。而Ⅰ组AST、LDH、HBDH在T2有所升高，在T3恢复；Ⅱ组AST、LDH、HBDH几乎无变化。结论髋关节置换术中使用骨水泥可使心肌酶谱和血清肌钙蛋白一过性升高，提示其具有潜在的心肌损害作用，术中、术后应加强容量补充和循环监测，确保患者安全。
Objective To observe：the effects of hip replacement combined bone cement on the level of serum cardiac enzyme, troponin Ⅰ（cTnⅠ） and to record ECG and hemodynamics changes,then to evaluate myocardial injury. Methods Sixty ASA Ⅰ -- Ⅱ patients were randomly divided into two groups ：group Ⅰ（with use of bone cement, 30 cases）,group Ⅱ（without use of bone cement, 30 cases）. The venous blood samples were taken to measure the serum levels of cardiac enzyme and cTnⅠ before operation（T1） ,4h after operation（T2） and 24h after operation （T3） ,ECG and hemodynamics changes were also observed. Results The change of cardiac enzyme and cTnI had no statistical difference between group Ⅰ and Ⅱ （P 〉0.05） ,while the level of cTnI and CK in group Ⅰ on T2 ,T3 were higher than group Ⅱ , then increased continuously on T3. In group Ⅰ, the values of AST, LDH, HBDH on T2 were varied increasing,and recovery on T3;AST,LDH, HBDH had no difference in group Ⅱ. Conclusion In hip replacement combined bone cement, cardiac enzyme and cTnⅠ rise temporarily, that indicates potential effect of myocardial injury. So,in operation and after operation, supplied volume and circulatory monitoring insure security of patients.
出处
《重庆医学》
CAS
CSCD
北大核心
2009年第4期462-463,共2页
Chongqing medicine
关键词
髋关节置换术
骨水泥
心肌损害
hip replacement
bone cement
myocardial injury
