摘要
目的探讨全髋关节置换术中骨水泥对老年患者凝血功能的影响。方法2004年7月至2005年3月，44例行骨水泥型全髋关节置换术患者，男21例，女23例；年龄55-78岁，平均64岁；股骨颈骨折21例，股骨头缺血性坏死15例，髋关节骨关节炎8例。对其凝血功能相关指标进行检测，包括血浆凝血酶原时间（胛）、活化的部分凝血酶原时间（APTT）、血浆纤维蛋白原（FIB）及鱼精蛋白副凝固试验（3P试验），分别于注入骨水泥前5min、注入骨水泥后30min及3h各检测一次。所有数据进行统计学处理。结果注入骨水泥后30minPT值较注入前5min显著缩短（R0．05）；而注入骨水泥后3h胛值与注入后30min比较，显著回升（P〈0．05）。FIB含量在注入骨水泥后30min较注入前5min明显增高（P〈0．05）；注入骨水泥后3h与注入后30min比较，差异有统计学意义（P〈0．05）。3P试验阳性率注入骨水泥后30min与注入骨水泥前5min比较，差异有统计学意义（R0．05）。骨水泥对AP丌影响不明显，注入3h后各项指标基本恢复。结论全髋关节置换术中注入骨水泥30min后PT缩短、FIB增高、3P试验的阳性率升高，但在3h后骨水泥对这些指标的影响基本消除，提示注入骨水泥后的3h内是严密监测病情的重要时段。在注入骨水泥后，老年患者凝血系统虽有高凝倾向，但各相关指标数值仍在正常值范围内。
Objective To assess the effects of bone cement implantation on coagulation functions during the total hip arthroplasty in elderly patients. Methods Forty-four patients admitted to our hospital between July 2004 and March 2005 involved in this study. There were 21 males, 23 females, with the mean age of 64 years （ranged, 55-78 years）, including femoral neck fractures in 21 patients, femoral head necrosis in 15 patients, and hip joint osteoarthritis in 8 patients. The relative parameters were observed in all patients, including prothrombin time （PT）, activated partial thromboplastin time （APTF）, plasma protamine paracoagulation test （3P test）, and fibrinogen （FIB）. Blood samples were measured 5 min before, 30 min and 3 hour af- ter bone cement implantation. The data were analyzed with SPSS11.5. Results PT significantly decreased at 30 min after bone cement implantation, compared with 5 min before implantation （P〈0.05）, and significantly recovered at 3 hour after implantation （P〈0.05）. FIB significantly increased at 30 min after implantation compared with 5 min before implantation （P〈 0.05）, and significanhy decreased again at 3 hour after implantation （P〈 0.05）. A higher rate of positive results in 3P test was observed at 30 min after implantation compared with 5 min before implantation （P〈 0.05）. There was no significant difference in APTF before and after implantation. Conclusion Bone cement shows a tendency to activate blood coagulation, especially in elderly persons, but the relative indexes are still in normal range.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2007年第10期736-738,共3页
Chinese Journal of Orthopaedics
