髋膝关节置换中骨水泥对血压及心率的影响同一机构行髋膝关节置换中充填骨水泥157例:对血压及心率影响的分析

目的：探讨关节置换过程中使用骨水泥对老年患者血压及心率的影响。方法：于2000-07/2008-03安徽医科大学附属安徽省立医院骨科入选股骨颈骨折行全髋关节置换患者93例，左髋54例，右髋39例，年龄60~70岁。骨性关节炎行全膝关节置换64例，左膝27例，右膝37例，年龄60~70岁。对其使用骨水泥前后血压及心率相关指标进行检测。结果：髋关节置换中使用骨水泥较膝关节置换中使用骨水泥患者收缩压降低明显。93例股骨颈骨折行全髋关节置换患者，统计其中90例不同麻醉方式患者使用骨水泥前后体征的变化。35例连续硬膜外麻醉的髋关节置换患者与55例全麻患者比较，骨水泥使用前后的收缩压、舒张压变化差异有显著性意义(P < 0.05)，心率差异无显著性意义(P > 0.05)。结论：关节置换尤其是全髋关节置换过程中注入骨水泥时必须严密监测血压。关键词：关节成形术；骨水泥；血压；心率

Blood pressure and heart rate in the implantation of bone cement during total hip replacement for 157 patients

OBJECTIVE: To explore the effect of implantation of bone cement on blood pressure and heart rate of the elderly during joint replacement. METHODS: A total of 93 cases of femoral neck fracture, including 54 left hips and 39 right hips, underwent total hip replacement (THR) in Department of Orthopedics, Anhui Provincial Hospital of Anhui Medical University between July 2000 and March 2008. The patients aged from 60 to 70 years. A total of 64 cases of osteoarthritis underwent total knee replacement, including 27 cases of left knees and 37 cases of right knees. The blood pressure and heart rate were detected before and after bone cement application.RESULTS: The systolic blood pressure of patients undergoing THR using bone cement was significantly reduced compared with patients undergoing total knee replacement. Of 93 patients, the signs of 90 patients with different anesthesia methods before and after bone cement application were analyzed. The 35 patients by epidural anesthesia showed significantly different systolic and diastolic blood pressure compared with 55 patients by general anesthesia (P < 0.05), while no difference was found in heart rate (P > 0.05). CONCLUSION: The blood pressure should be rigorously monitored in implantation of bone cement during joint replacement, in particular THR.