经皮椎体成形使用骨水泥对心血管系统的影响  

Cardiovascular effects of polymethylmethacrylate in percutaneous vertebroplasty

作　　者：宋奇志[1] 李涛[1] 奉成斌 林亚军[1] 洪浩[1] 

机构地区：[1]重钢总医院骨科,重庆市400080

出　　处：《中国组织工程研究》2014年第21期3374-3379,共6页Chinese Journal of Tissue Engineering Research

基　　金：2013年重庆市卫生局医学科研项目"唑来膦酸预防高龄患者骨质疏松骨折后再骨折"~~

摘　　要：背景:目前关于经皮椎体成形中注射聚甲基丙烯酸甲酯骨水泥对患者心血管系统及呼吸系统不良反应影响的系统性研究非常有限。目的:探讨经皮椎体成形中使用聚甲基丙烯酸甲酯骨水泥对患者心血管系统的影响。方法:回顾性分析2011年7月至2013年9月经皮椎体成形治疗患者的临床资料,共104例167个椎体,根据麻醉记录对局部麻醉前、聚甲基丙烯酸甲酯注射前、聚甲基丙烯酸甲酯注射后0,3,5,10 min 6个时间点的平均动脉压、心率及血氧饱和度进行比较分析。结果与结论:与聚甲基丙烯酸甲酯注射前相比,聚甲基丙烯酸甲酯注射后0,3,5 min均出现平均动脉压下降,以3 min时最为明显(P<0.05,P<0.01),10 min时恢复到注射前水平;同时心率也表现为聚甲基丙烯酸甲酯注射后0,3,5 min时间点明显加快,同样以3 min时最为明显(P<0.05,P<0.01),10 min时心率基本恢复到注射前水平。聚甲基丙烯酸甲酯注射前后所有时间点的血氧饱和度均在95%以上,与聚甲基丙烯酸甲酯注射前相比,注射后各时间点的血氧饱和度百分数均无明显变化。表明经皮椎体成形中注入聚甲基丙烯酸甲酯会对患者心血管系统产生一过性的影响。BACKGROUND：The study on polymethylmethacrylate effects on the cardiovascular system during percutaneous vertebroplasty is limited. OBJECTIVE：To estimate the effects of polymethylmethacrylate on the cardiovascular system during percutaneous vertebroplasty. METHODS：From July 2011 to September 2013, a total of 104 patients （167 vertebral bodies） with osteoporotic vertebral compression fractures and without serious cardiovascular related basic diseases were enrol ed in this retrospective study. Mean arterial pressure, heart rate and oxygen saturation were recorded at the fol owing time points：before local anesthesia, before polymethylmethacrylate injection, 0, 3, 5 and 10 minutes after polymethylmethacrylate injection. RESULTS AND CONCLUSION：The mean arterial pressure was decreased after polymethylmethacrylate injection at 0, 5 minutes （P〈0.05） and 3 minutes （P〈0.01）, and returned to the pre-injection level at 10 minutes. At the same time, the heart rate was increased after polymethylmethacrylate injection at 0, 5 minutes （P〈0.05） and 3 minutes （P〈0.01）, and returned to the pre-injection level at 10 minutes. Oxygen saturation was over 95%, which was unchanged before and after polymethylmethacrylate injection. The results indicated that polymethylmethacrylate injection has a transient effect on cardiovascular system during percutaneous vertebroplasty.

关 键 词：生物材料 骨生物材料 经皮椎体成形 聚甲基丙烯酸甲酯 血压 心率 血氧饱和度 

分 类 号：R318[医药卫生—生物医学工程]