氢化泼尼松用于预防老年患者关节置换术中骨水泥植入综合征的发生

发布时间：2019-07-03 17:22

【摘要】：目的观察预注氢化泼尼松对老年患者关节置换术中骨水泥植入综合征的影响。方法择期行人工关节置换术老年患者51例,随机均分为三组,每组17例：非骨水泥组患者在行人工关节置换术时使用非骨水泥型人工关节；骨水泥组患者在行人工关节置换术植入骨水泥前未预先用药；氢化泼尼松预处理组在骨水泥准备时缓慢静注氢化泼尼松0.3mg/kg,每组17人。记录三组患者骨水泥植入前1分钟(T0),植入时(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)时的心率、血压及血氧饱和度变化,同时记录急救药物的使用情况。结果与T0时比较,非骨水泥组在T1-T6时收缩压降低(P0.05),骨水泥组在T2～T6时降低(P0.05),氢化泼尼松预处理组6个时间段差异均无统计学意义(P0.05)；氢化泼尼松组在T3-T5时收缩压阳性率低于其他两组(P0.05)。与T0时比较,非骨水泥组在T2～T6时舒张压降低(P0.05),骨水泥组在T2-T5时降低(P0.05),氢化泼尼松预处理组6个时间段差异均无统计学意义(P0.05);氢化泼尼松组舒张压阳性率低于其他两组(P0.05)。三组心率、脉氧饱和度差异均无统计学意义。氢化泼尼松预处理组麻黄碱使用率小于其他两组。结论在本试验条件下,预注0.3mg/kg的氢化泼尼松可以降低老年患者行人工关节置换术骨水泥植入综合征的发生。
[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.
【学位授予单位】：南京大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.4

【参考文献】