文章摘要
李刚,赵涛,韩永彬,吕刚,郑升法.间羟胺对骨水泥置入老年患者的影响[J].,2019,27(17):1543-1548
间羟胺对骨水泥置入老年患者的影响
Effects of metaraminol on hemodynamics and tissue oxygen metabolism in elderly patients undergoing total kneearthroplasty and cement implantation
Received:April 15, 2019  Revised:May 27, 2019
DOI:
中文关键词: 骨水泥置入综合征, 氧代谢, 间羟胺
英文关键词: cement implantation syndrome, oxygen metabolism, metaraminol
基金项目:
Author NameAffiliation
LI Gang  
ZHAO Tao  
HAN Yong-bin  
LV Gang  
ZHENG Sheng-fa  
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中文摘要:
      摘要:[目的]探讨间羟胺对老年全膝关节置换骨水泥置入患者组织氧代谢的影响。[方法]选取本院择期初次 行单侧骨水泥型全膝关节置换术的老年患者 60 例,采用随机数字表法,随机分为生理盐水组(盐水组)和间羟胺组 (间羟胺组),每组 30 例。间羟胺组在扩髓腔时给予间羟胺 0.03~0.3 μg /(kg · min)持续静脉泵注,盐水组给予生理 盐水泵注。术中血压低于 30%基础血压静脉单次给予 0.1~0.2 mg 间羟胺静注。记录两组患者于骨水泥置入前(T0)、 骨水泥置入后 5 min (T1)、10 min (T2)、30 min (T3) 的平均动脉压 (MAP)、中心静脉压 (CVP)、心率 (HR), 采集动脉血和中心静脉血的血样,进行血气分析,同时,记录围术期Ⅱ导联心电图心律失常的发生情况,记录术后 患者恶心、呕吐发生情况。[结果] 与 T0 比较,盐水组患者在 T1 和 T2 的 MAP、PaO2、PcvO2、ScvO2、Lac、 CaO2、CcvO2均降低、HR、Da-cvO2、ERO2均升高;与盐水组比较,在 T2 时间羟胺组患者 MAP、PaO2、PcvO2、Sc? vO2、Lac、CaO2、CcvO2 均升高,HR、Da-cvO2、ERO2 均降低。与盐水组比较,间羟胺组患者术中心律失常的发生 率和术后恶心呕吐发生率均降低。[结论]间羟胺改善老年患者全膝关节置换术中骨水泥置入引起的血流动力学的变 化,有效保证组织氧代谢。
英文摘要:
      Abstract:[Objective] To investigate the effects of metaraminol on hemodynamics and tissue oxygen metabolism in elderly patients undergoing total knee arthroplasty and cement implantation. [Methods] Sixty elderly patients undergoing unilateral ce? mented total knee arthroplasty were randomly divided into saline infusion group and metaraminol infusion group with 30 cases in each group by random numerical table method. The patients in metaraminol infusion group received intravenous infusion of metaraminol 0.03~0.3 ug/kg/min while saline infusion group received saline infusion. Metaraminol (0.1~0.2 mg) should be in? jected by intravenous, when blood pressure was below 30% of baseline blood pressure during operation. Mean arterial pressure (MAP) , central venous pressure (CVP) and heart rate (HR) were measured before cement implantation (T0) , 5 minutes (T1) , 10 minutes (T2) and 30 minutes (T3) after cement implantation in both two groups. Blood samples of arterial blood and central ve? nous blood were collected for blood gas analysis, arterial blood lactate concentration (Lac) , hemoglobin volume (Hb) , arterial partial pressure of oxygen (PaO2) , central venous oxygen saturation (ScvO2) , and partial pressure of central venous oxygen (Pc? vO2) were recorded. According to Fick formula, arterial oxygen content (CaO2) , central venous oxygen content (CcvO2) , arterial venous oxygen difference (Da-cvO2) , and oxygen uptake rate (ERO2) were calculated. Perioperative arrhythmia of lead II elec? trocardiogram and postoperative nausea and vomiting were recorded. [Results] Compared with thos at T0, MAP, PaO2, PcvO2, ScvO2, Lac, CaO2, and CcvO2 of patients decreased, and HR, Da-cvO2, and ERO2 increased at T1 and T2 in saline infusion group. Compared with saline infusion group, MAP, PaO2, Pc? vO2, ScvO2, Lac, CaO2, and CcvO2 of patients increased, and HR, Da-cvO2, and ERO2 decreased at T2 in metaraminol in? fusion group. Compared with saline infusion group, the inci? dence of intraoperative arrhythmia and postoperative nausea and vomiting decreased in metaraminol infusion group. [Conclusion] Metaraminol improves the hemodynamic changes caused by cement implantation during total knee arthroplasty in elderly patients, and effectively ensures tissue oxygen metabolism.
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