骨水泥型全髋关节置换凝血功能及血流动力学相关不良反应的回顾性分析

发布时间：2018-06-03 00:13

本文选题：全髋关节置换术 + 骨水泥　；参考：《广西医科大学》2017年硕士论文

【摘要】：目的:讨论于人工全髋关节假体置换术(THA)应用骨水泥病人凝血功能及血流动力学的变化及不良反应。方法:回顾性分析2013年1月至2016年12月期间在我院行THA患者80例。按照患者所使用假体类型差异分为骨水泥型人工全髋关节置换组(A组,40例)及生物型人工全髋关节置换组(B组,40例)。收集患者术中心率(HR)、平均动脉压(MAP)变化情况,以及术前、术后首日凝血功能检查相应指标,记录术后早期患者并发症及不良反应发生情况。结果:术后首日A、B两组PLT(血小板)水平较术前均有明显下降,且组间比较无显著差异(P0.05)。A组PT(凝血酶原时间)、FIB(血浆纤维蛋白原)较术前显著上升(P0.05),B组PT、FIB较术前无明显上升(P0.05)。两组术后APTT(活化部分凝血活酶时间)相比术前均无显著差异(P0.05)。A组置入骨水泥后HR、MAP变化明显。与TA相比,A组中TB、TC、TD、TE各时刻MAP显著降低,差别具有统计学意义(P0.05),而B组中平均动脉压在各个时间段未见显著改变(P0.05)。与TA相比,A组中TB、TC、TD、TE各时间点心率升高明显,差异有统计学意义(P0.05),而B组HR在各个时间点无显著改变(P0.05)。A、B组术后前期不良反应未见显著差别。结论:骨水泥型THA患者术后首日PT、FIB较生物型THA患者明显升高,两组APTT值均无明显变化,提示骨水泥型THA患者术后高凝倾向,血栓形成风险上升。骨水泥型THA患者术中心率明显升高,平均动脉压明显降低,提示骨水泥型THA患者术中血流动力学相关风险升高。
[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.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.4

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