【摘要】：目的觀察預注氫化潑尼松對老年患者關節(jié)置換術中骨水泥植入綜合征的影響。方法擇期行人工關節(jié)置換術老年患者51例,隨機均分為三組,每組17例：非骨水泥組患者在行人工關節(jié)置換術時使用非骨水泥型人工關節(jié)；骨水泥組患者在行人工關節(jié)置換術植入骨水泥前未預先用藥；氫化潑尼松預處理組在骨水泥準備時緩慢靜注氫化潑尼松0.3mg/kg,每組17人。記錄三組患者骨水泥植入前1分鐘(T0),植入時(T1),植入后1 min(T2),植入后3min(T3),植入后5min(T4),植入后10min(T5),植入后30min(T6)時的心率、血壓及血氧飽和度變化,同時記錄急救藥物的使用情況。結果與T0時比較,非骨水泥組在T1-T6時收縮壓降低(P0.05),骨水泥組在T2～T6時降低(P0.05),氫化潑尼松預處理組6個時間段差異均無統(tǒng)計學意義(P0.05)；氫化潑尼松組在T3-T5時收縮壓陽性率低于其他兩組(P0.05)。與T0時比較,非骨水泥組在T2～T6時舒張壓降低(P0.05),骨水泥組在T2-T5時降低(P0.05),氫化潑尼松預處理組6個時間段差異均無統(tǒng)計學意義(P0.05);氫化潑尼松組舒張壓陽性率低于其他兩組(P0.05)。三組心率、脈氧飽和度差異均無統(tǒng)計學意義。氫化潑尼松預處理組麻黃堿使用率小于其他兩組。結論在本試驗條件下,預注0.3mg/kg的氫化潑尼松可以降低老年患者行人工關節(jié)置換術骨水泥植入綜合征的發(fā)生。
[Abstract]:Objective to observe the effect of preinjection of hydroprednisone on bone cement implantation syndrome in elderly patients undergoing joint replacement. Methods 51 elderly patients undergoing artificial joint replacement were randomly divided into three groups: 17 patients in non-bone cement group were treated with non-bone cement artificial joint replacement, 17 patients in bone cement group were treated with hydroprednisone 0.3 mg 路kg ~ (- 1) intravenously before bone cement implantation, and 17 patients in each group were treated with hydroprednisone 0.3 mg 路kg ~ (- 1) intravenously. The changes of heart rate, blood pressure and blood oxygen saturation of bone cement were recorded 1 minute before implantation (T0), T1 (T1), 1 min (T2), T3 (T3), 5min (T 4), 10min (T5), 30min (T6). At the same time, the use of emergency drugs was recorded. Results compared with T0, the systolic blood pressure of non-bone cement group decreased at T1-T6 (P 0.05), bone cement group decreased at T2~T6 (P 0.05), hydroprednisone pretreatment group had no significant difference in 6 time periods (P 0.05), and the positive rate of systolic blood pressure in hydroprednisone group was lower than that in the other two groups at T3-T5 (P 0.05). Compared with T0, diastolic blood pressure in non-bone cement group decreased at T2~T6 (P 0.05), bone cement group decreased at T2-T5 (P 0.05), hydroprednisone pretreatment group had no significant difference in 6 time periods (P 0.05), and the positive rate of diastolic blood pressure in hydroprednisone group was lower than that in the other two groups (P 0.05). There was no significant difference in heart rate and pulse oxygen saturation among the three groups. The utilization rate of ephedrine in hydroprednisone pretreatment group was lower than that in the other two groups. Conclusion preinjection of hydroprednisone with 0.3mg/kg can reduce the incidence of bone cement implantation syndrome in elderly patients undergoing artificial joint replacement.
【學位授予單位】：南京大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R687.4

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本文編號：2509551