| 止血带使用时间与全膝关节置换术肺脂肪栓塞风险的实验研究 |
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| 引用本文： | 刘宏滨,张阳,钱齐荣,刘宁,郑玮杰. 止血带使用时间与全膝关节置换术肺脂肪栓塞风险的实验研究[J]. 中国矫形外科杂志, 2011, 19(20): 1734-1737 |
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| 作者姓名： | 刘宏滨 张阳 钱齐荣 刘宁 郑玮杰 |
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| 作者单位： | 解放军97医院骨科;北京军区总医院全军创伤骨科研究所;上海长征医院骨科; |
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| 摘 要： | [目的]探讨全膝关节置换术中止血带的使用与肺脂肪栓塞产生的相关性。[方法]32只健康犬随机分为四组,A组:模拟全膝关节置换术,截骨、扩髓,插入髓内杆,术中使用止血带60 min;B组:操作同A组,术中使用止血带90 min;C组:术中操作同A组,术中不使用止血带;D组:术中仅使用止血带60 min,不模拟全膝关节置换。术中监测不同时间动脉血气分析和凝血指标,术后进行肺脏病理检查并采用病理学评分计算肺损伤程度。统计分析采用卡方检验和非参数检验。[结果]不考虑时间因素时,止血带90 min组与其余组比较,PaO2差异显著(F=3.013,P=0.047),考虑时间因素时,止血带90 min组在术毕和术后5 min时,Pa O2差异亦显著(F=3.427,P=0.029)。PaCO2各组间在术中术后无统计学差异。凝血指标中两组各时间点PT、APTT无显著差异(F=0.616,P=0.61)。肺组织病理切片显示:肺损伤总分止血带90 min组高于其余各组(x2=19.996,P=0.001)。[结论]全膝关节置换术后止血带释放时可能干扰呼吸系统功能,增加肺脏脂肪栓塞的发生风险,尤其在止血带使用时间达到90 min时。
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| 关 键 词： | 关节成形术 膝 置换 止血带 肺脂肪栓塞 |
The experimental study on risk between tourniquet and fat pulmonary embolism following total knee arthroplasty |
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| LIU Hong-bin,ZHANG Yang,QIAN Qi-rong,et al.. The experimental study on risk between tourniquet and fat pulmonary embolism following total knee arthroplasty[J]. Orthopedic Journal of China, 2011, 19(20): 1734-1737 |
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| Authors: | LIU Hong-bin ZHANG Yang QIAN Qi-rong et al. |
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| Affiliation: | LIU Hong-bin,ZHANG Yang,QIAN Qi-rong,et al.Department of Orthopedics,the 97th Hospital of PLA,Xuzhou 221004,China |
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| Abstract: | [Objective] To investigate whether a tourniquet could increase the risk of fat pulmonary embolisms in total knee arthroplasty(TKA).[Method]Thirty-two dogs were randomized into 4 groups:group A was underwent simulated TKA with a tourniquet in 60 minutes(n=8),group B was underwent simulated TKA with a tourniquet in 90 minutes(n=8),group C without a tourniquet(n=8) and group D was treated as controlled group with a tourniquet in 60 minutes(n=8).Arterial blood gas analysis(PaO2 and PaCO2) and index of blood coa... |
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| Keywords: | arthroplasty knee replacement tourniquet fat pulmonary embolism |
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