本文選題：全髖關(guān)節(jié)置換術(shù) + 骨水泥��； 參考：《廣西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:討論于人工全髖關(guān)節(jié)假體置換術(shù)(THA)應(yīng)用骨水泥病人凝血功能及血流動(dòng)力學(xué)的變化及不良反應(yīng)。方法:回顧性分析2013年1月至2016年12月期間在我院行THA患者80例。按照患者所使用假體類型差異分為骨水泥型人工全髖關(guān)節(jié)置換組(A組,40例)及生物型人工全髖關(guān)節(jié)置換組(B組,40例)。收集患者術(shù)中心率(HR)、平均動(dòng)脈壓(MAP)變化情況,以及術(shù)前、術(shù)后首日凝血功能檢查相應(yīng)指標(biāo),記錄術(shù)后早期患者并發(fā)癥及不良反應(yīng)發(fā)生情況。結(jié)果:術(shù)后首日A、B兩組PLT(血小板)水平較術(shù)前均有明顯下降,且組間比較無顯著差異(P0.05)。A組PT(凝血酶原時(shí)間)、FIB(血漿纖維蛋白原)較術(shù)前顯著上升(P0.05),B組PT、FIB較術(shù)前無明顯上升(P0.05)。兩組術(shù)后APTT(活化部分凝血活酶時(shí)間)相比術(shù)前均無顯著差異(P0.05)。A組置入骨水泥后HR、MAP變化明顯。與TA相比,A組中TB、TC、TD、TE各時(shí)刻MAP顯著降低,差別具有統(tǒng)計(jì)學(xué)意義(P0.05),而B組中平均動(dòng)脈壓在各個(gè)時(shí)間段未見顯著改變(P0.05)。與TA相比,A組中TB、TC、TD、TE各時(shí)間點(diǎn)心率升高明顯,差異有統(tǒng)計(jì)學(xué)意義(P0.05),而B組HR在各個(gè)時(shí)間點(diǎn)無顯著改變(P0.05)。A、B組術(shù)后前期不良反應(yīng)未見顯著差別。結(jié)論:骨水泥型THA患者術(shù)后首日PT、FIB較生物型THA患者明顯升高,兩組APTT值均無明顯變化,提示骨水泥型THA患者術(shù)后高凝傾向,血栓形成風(fēng)險(xiǎn)上升。骨水泥型THA患者術(shù)中心率明顯升高,平均動(dòng)脈壓明顯降低,提示骨水泥型THA患者術(shù)中血流動(dòng)力學(xué)相關(guān)風(fēng)險(xiǎn)升高。
[Abstract]:Objective: to discuss the changes of blood coagulation function and hemodynamics and adverse reactions in patients with total hip prosthesis replacement (THAA). Methods: 80 cases of THA in our hospital from January 2013 to December 2016 were analyzed retrospectively. According to the type of prosthesis used in the patients, 40 cases were divided into bone cement total hip replacement group (n = 40) and biological total hip replacement group (n = 40). The changes of heart rate HRV and mean arterial pressure (MAPP) during operation and the corresponding indexes of coagulation function before and after operation were collected. The complications and adverse reactions of the patients in the early postoperative period were recorded. Results: on the first day after operation, the levels of PLT (platelet) in group A and B were significantly lower than those before operation, and there was no significant difference between the two groups. The plasma fibrinogen (FIBs) in group A (plasma fibrinogen) was significantly higher than that in group B (P 0.05), and the FIB of PTT in group B was not significantly higher than that in group B (P 0.05). There was no significant difference in APTT (activated partial thromboplastin time) between the two groups. Compared with TA group, the MAP of group A was significantly lower than that of group A (P 0.05), but the mean arterial pressure in group B did not change significantly at every time. Compared with TA group, the heart rate of TBX TCU TDNTE increased significantly at each time point, and the difference was statistically significant (P 0.05), but there was no significant change in HR in group B at each time point. There was no significant difference in early postoperative adverse reactions between group B and group B (P 0.05). Conclusion: on the first day after operation, the APTT of bone cement type THA patients was significantly higher than that of biological THA patients, and the APTT values of the two groups had no significant change, which suggested that the patients with bone cement type THA had high coagulation tendency and increased risk of thrombogenesis. The operative center rate and mean arterial pressure were significantly increased and mean arterial pressure decreased in patients with bone cement type THA, suggesting that the risk of hemodynamics was increased in patients with bone cement type THA.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R687.4

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