摘要
目的探讨乌司他丁联合微量肾上腺素在骨水泥型人工髋关节置换术中预防骨水泥植入综合征（BCIS）发生的作用。方法回顾性研究自2010-01—2013-11施行的骨水泥型人工髋关节置换术48例．其中骨水泥植入前未用乌司他丁及肾上腺素者（对照组）36例，骨水泥植入前用乌司他丁联合微量肾上腺素者（干预组）12例。比较2组骨水泥植人前及植入后1、5、10、15min的收缩压（SBP）、舒张压（DBP）、心率（HR）、指末梢血氧饱和度（SpO2）。结果对照组：血压在骨水泥注入后均有不同程度下降，骨水泥植入1min时血压显著下降（P〈0．05），5rain后开始回升（P〈0．05），10-15min时基本恢复；HR和SpO2无明显变化（P〉0．05）。干预组：骨水泥植入前30min微量泵入肾上腺素及30万U乌司他丁，骨水泥灌注前后各时间点SBP、DBP、HR、Sp02均无明显变化（P〉0．05）。结论微量肾上腺素联合乌司他丁静脉泵入能有效预防BCIS的发生。
Objective To investigate the clinical application of epinephrine hydrochloride associated with ulinastatin in the prevention of bone cement implantation syndrome in hip arthroplasty. Methods Forty-eight elderly patients undergoing cemented hip arthroplasty from January 2010 to November 2013 were retrospectively analyzed. All the patients were divided into control group and intervention group. Patients in the control group were not pretreated with epinephrine and ulinastatin at 30 min before implantation of bone cement while patients in intervention group were protreated with intravenous pump of epinephrine and hlinastatin. Parameters of systolic blood pressure （SBP）, diastolic blood pressure （DBP）, heart rate（HR）and pulse oxygen saturation （SpO2） of all patients were recorded as fallowing points： 30 win before bone cement implantation and immediately, 1, 5, 10 and 15 win after bone cement implantation. Results In the control group： the SBP, DBP were decreased in control group one minute after bone cement implantation（P 〈0.05）. The blood pressure was increased 5 min after implantation（P 〈0.05）, and recovered to basis 10 to 15 win later. There was no significant change in HR and SpO2（P 〉0.05）. In the intervention group, patients were infused intravenously with micro-dose epinephrine and 300 thousands units of ulinastatin at 30 win before bone cement implantation. No significant difference was found in SBP, DBP, HR and SpO2 at the same time points as those in control group（P 〉0.05 ）. Conclusion Pretreatment of low dose of epinephrine and ulinatatin can effectively prevent bone cement implantation syndrome.
出处
《中国骨与关节损伤杂志》
2014年第4期316-318,共3页
Chinese Journal of Bone and Joint Injury
基金
昆明市延安医院院内项目(YYKY012-19)
