经皮穿刺脊椎成形术中聚甲基丙烯酸甲酯对心血管系统的影响  

Effects of Polymethylmethacrylate to Cardiovascular System in Percutaneous Vertebroplasty

作　　者：朱云章[1] 赵平[2] 冯春林[1] 王文杰[1] 

机构地区：[1]沈阳市骨科医院,沈阳110044 [2]沈阳体育学院,沈阳110102

出　　处：《临床误诊误治》2008年第12期4-5,共2页Clinical Misdiagnosis & Mistherapy

摘　　要：目的:评估经皮穿刺脊椎成形术(PVP)中注射聚甲基丙烯酸甲酯(PMMA)对患者心血管系统的影响。方法:对48例实施PVP患者分别于术前、PMMA注射过程中、注射后监测平均动脉压(MAP)、心率、脉搏及脉搏氧饱和度(SpO2),并应用多元回归模型分析心血管系统变化及与并发症的关联性。结果:MAP在PMMA注射中、注射后5 min、10 min分别为94.0 mmHg、97.3 mmHg和97.5 mmHg,与注射前(92.2 mmHg)比较差异无统计学意义(P=0.19,0.23,0.24);心率在注射中、注射后5 min、10 min平均分别为80.5/min、80.4/min和80.0/min,与注射前(80.5/min)比较差异无统计学意义(P=0.71,0.92,0.65);SpO2在注射中、注射后5 min、10 min分别为98.0%、98.0%和97.4%,与注射前(98.0%)比较差异无统计学意义(P=0.80,0.89);SpO2的4个最低值出现在注射后10 min,与注射前比较,差异具有统计学意义(P=0.007),但SpO2平均值与注射前比较差异无统计学意义(P>0.05)。PVP中PMMA的注射与机体心血管变化无显著性关联。结论:PVP中注射PMMA安全,对心血管无明显影响。Objective：To evaluate the effects of PMMA injection on vital signs of cardiovascular system during percutaneous vertebroplasty （PVP）. Methods： In 48 patients, statistical data of blood pressure, heart rate, and arterial oxygen saturation obtained before, during, 5 min after,and 10 min after PMMA injection during percutaneous vertebroplasty were used to ascertain the effects of cardiopulmonary comorbidities and on vital signs of complications with muhivariable regression modeling. Results ：The mean arterial blood pressure and heart rate during,5 minutes after,and 10 minutes after PMMA injection were 94.0 mmHg,97.3 mmHg and 97.5 mmHg respectively and were not significantly different from their respective preprocedure values （ P = 0.19, 0.23,0.24）. Values for oxygen saturation during PMMA injection and 5 minutes thereafter were 80.5/min,80.4/min and 80.0/min and were not significantly different from preprocedure values（P = 0. 71,0： 92,0.65 ）. SpO2 during,5 min, 10 min after injection were 98.0% ,98.0% and 97.4% respectively and were not significantly different from that（98.0% ） before injection（P = 0. 80,0. 89） . But in 4cases oxygen saturation was significantly lower at 10 minutes after injection than before injection（P = 0. 007 ）, although the mean difference was negligible. There seemed to be little association between PMMA injection in PVP and cardiovascular changes. Conclusion：There seems to be no significant association between PMMA injection and systemic cardiovascular derangement during percutaneous vertebroplasty.

关 键 词：经皮穿刺脊椎成形术 骨质疏松 骨折 聚甲基丙烯酸甲酯 心血管系统 手术后并发症 

分 类 号：R687[医药卫生—骨科学]