髋关节置换术中骨水泥填充对血压的影响及干预  

Effect of cement implantation and pressor agents in hip replacement on blood pressure

作　　者：郭蒙[1] 姜保国[1] 付中国[1] 张殿英[1] 

机构地区：[1]北京大学人民医院创伤骨科、北京大学交通医学中心,北京100044

出　　处：《北京大学学报（医学版）》2013年第5期693-697,共5页Journal of Peking University:Health Sciences

基　　金：“十一五”国家科技支撑计划重点项目(2007BAI04806)资助~~

摘　　要：目的:探讨髋关节置换术中不同干预条件下使用骨水泥对血压的影响。方法:对2008年7月至2013年7月北京大学人民医院创伤骨科住院因股骨颈骨折行骨水泥型人工髋关节置换术患者进行回顾性分析,入选患者共172例,根据麻醉记录对其使用骨水泥前后血压变化及升压药物使用情况进行分析。根据升压药使用情况将入选患者分为未用升压药干预组、骨水泥使用前使用升压药组、骨水泥使用后使用升压药组、骨水泥使用前后均使用升压药组共4组,对得到的数据进行统计学分析。结果:未用升压药干预组88例,使用了骨水泥后收缩压下降(4.0±10.3)mmHg(1 mmHg=0.133 kPa),差异有统计学意义(t=3.660,P=0.000),舒张压下降(1.3±7.5)mmHg,但差异无统计学意义(t=2.286,P=0.149)。骨水泥使用前以升压药干预组19例,使用骨水泥后收缩压下降(0.5±20.2)mmHg,但差异无统计学意义(t=0.114,P=0.911),舒张压升高(0.7±10.2)mmHg,差异无统计学意义(t=-0.316,P=0.756)。骨水泥使用后以升压药物干预组48例,使用骨水泥后收缩压下降(6.9±15.0)mmHg,差异有统计学意义(t=3.195,P=0.002),舒张压下降(3.6±7.4)mmHg,差异有统计学意义(t=3.407,P=0.001)。骨水泥使用前后均使用升压药干预组17例,使用骨水泥后收缩压下降(5.0±12.2)mmHg,差异无统计学意义(t=1.667,P=0.115),舒张压上升(1.3±8.5)mmHg,差异无统计学意义(t=-0.656,P=0.521)。结论:髋关节置换术中使用骨水泥可导致血压降低,预防性使用升压药物可以发挥稳定血压作用并缩短血压降低时间。Objective：To discuss the change of blood pressure involved by pressor agents after the im- plantation of cement in hip replacement. Methods ： A total of 172 cases of femoral neck fracture under- went hip replacement in Department of Orthopedics and Trauma, Peking University People＇ s Hospital be- tween July 2008 and July 2013 were involved in this retrospective study. The blood pressure and usage of pressor agents were recorded before and after bone cement implantation. The data of blood pressure and usage of agents were collected according to anesthesia records. All the cases were divided into four groups by the application of pressor agents ： Free of using agent group （ Free-agent group）, agents used before implantation of cement group （ Pre-agent group）, agents used after implantation of cement group （ Post- agent group） and agent used before ＆ after implantation of cement group （ Pre ＆ Post-agent group）. Fur- ther statistic analysis was then performed. Results： Free-agent group＇ s mean systolic blood pressure de- creased for （4.0± 10.3 ） mmHg. The decreasing was significant （ t = 3. 660, P = 0.000）. Free-agent group＇ s mean diastolic blood pressure decreased （ 1.3 ± 7.5 ） mmHg. The decreasing was not significant （ t = 2. 286, P = 0. 149）. Pre-agent group＇ s mean systolic blood pressure decreased for （0.5 ± 20.2） mmHg. The decreasing was not significant （ t = 0.114, P = 0. 911 ）. Pre-agent group＇ s mean diastolic blood pressure increased （0.7 ± 10.2） mmHg. The increasing was not significant （t = -0.316, P = 0.756）. Post-agent group＇s mean systolic blood pressure decreased for （6.9 ± 15.0） mmHg. The de- creasing was significant （t = 3. 195, P = 0.002）. Post-agent group＇s mean diastolic blood pressure de- creased （3.6 ±7.4） mmHg. The decreasing was significant （ t = 3. 407, P = 0.001 ）. Pre ＆ post-agent group＇ s mean systolic blood pressure decreased for （5.0±12.2） mmHg. The decreasing was not signifi- cant �

关 键 词：关节成形术 置换 髋 骨黏合剂 血压 综合征 

分 类 号：R681.6[医药卫生—骨科学]