人工全髋关节置换术中急性心肺功能障碍

目的：探讨预防和降低人工全髋关节置换手术中急性心肺功能障碍危险 程度的措施。方法：对3例人工全髋关节置换手术中发生急性心肺功能障碍病人的临床特点进行综合分析。结果：股骨髓腔内压力增高导致栓塞是手术中急性心肺功能障碍发生的最重要因素。病人术前的身体状况和麻醉方式是影响其严重程度的相关因素。结论；人工全髋关节置换，尤其是骨水泥型关节置换时应高度警惕股骨假体插入时急性心肺功能障碍的发生。 股骨假体尽量采用非骨水泥固定方法或骨真空骨水泥技术固定。使用骨水泥前一定要彻底冲洗股骨髓腔和充分纠正低血容量。麻醉以插管全麻为宜。

Acute cardiorespiratory dysfunction during total hip arthroplasty.

Objective To evaluate the preventive measures for decreasing the risk degree associated with acute cardiorespiratory dysfunction during the total hip arthroplasty.Methods Three cases of acute cardiorespiratory dysfunction during the total hip arthroplasty were evaluated of which clinical characteristics were synthetic ally analyzed.Results An increase in intramedullary pressure in the femur leading to embolism was the most important factor for the development of acute cardiorespiratory dysfunction during the operation.Health conditions before the operation and the way of anesthesia were related factors to influence the severity.Conclusion In the process of insertion of the femoral component during the total hip arthroplasty,especially fixation of the femoral component with cement, acute cardiorespiratory dysfunction should be carefully observed. The femoral component with no cement or the use of a bone vacuum cementing technique can be adopted. The femoral medullary should be washed thoroughly and hypovolemia should be corrected before the cement is used.General anesthesia through cannulation is recommended.