经皮椎体成形术中骨水泥对老年骨质疏松症患者凝血功能的影响

目的 观察经皮椎体成形术(PVP)中骨水泥对老年骨质疏松症患者凝血功能的影响.方法 于椎弓根穿刺前10 min、注入骨水泥后1、20 min、2 h分别抽血检测11例患者的凝血功能相关指标,包括血浆凝血酶原时间(PT)、活化的部分凝血酶原时间(APTT)、血浆纤维蛋白原(FIB)和鱼精蛋白副凝固实验(3P实验),并汇总数据进行统计学分析.结果 PVP中骨水泥注入后20 min,PT缩短、FIB增高、3P实验阳性率升高(P<0.05),骨水泥注入2 h后基本恢复至注入前水平.除1例患者PTA术后2 h稍高于正常值(126%),其余患者各个时间点的各项指标均在正常参考值范围内.结论 PVP术中注入骨水泥对于凝血功能正常的患者基本安全,但在注入后会产生一过性轻微的高凝倾向.

The effects of bone cement injection on coagulation function during percutaneous vertebroplasty

Objective To investigate the effects of bone cement injection during pereutaneous vertcbroplasty (PVP) on coagulation function in elderly patients. Methods Four parameters were measured in 11 elderly female patients to observe changes in coaguLation function, including prothrombin time(PT) ,activated partial thromboplastin time (APTT) ,plasma protamine paracoagalation (3Ptest), and fibrinogen (FIB). Blood sampos were measured 10 min before tran-pediele puncturing,and 1 rain,20 min and 2 h after bone cement injection. The expermental data were analyzed with SPSS 11.0. Results Twenty rain after bone cement injection during PVP, PT was shortened, and FIB and positive rate of 3Ptest were increased ( P < 0.05 ). There was no significant change in APTT before and after bone cement injection.All indexes of 11 patients at different time points within the normal value basically. Conclusion Bone cement injection during PVP was safe to patients whose coagulation function was normal before PVP. But the expermental data showed a slight tendency to activate blood coagulation.