中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (25): 4665-4668.doi: 10.3969/j.issn.1673-8225.2010.25.026

• 生物材料临床实践 clinical practice of biomaterials • 上一篇    下一篇

充填骨水泥与人工髋关节置换后的凝血功能

尹俊萍1，关凤英2，苗海敏3，乔国勇4   

  1. 1邯邢矿山管理局总医院检验科，河北省邯郸市 056002；2邯郸市第一医院检验科，河北省邯郸市 056002；3邯郸市中医院手术室，河北省邯郸市 056002；4河北工程大学附属医院骨二科，河北省邯郸市  056029
  • 出版日期:2010-06-18 发布日期:2010-06-18
  • 通讯作者: 乔国勇，硕士，主治医师，河北工程大学附属医院骨二科，qiaoguoyong 2008@126.com
  • 作者简介:尹俊萍，女，1974年生，河北省邯郸市人，汉族，河北工程大学临床医学系毕业，主诊检验师，主要从事临床检验方面的研究。 qiaoguoyong2008@126.com

Effect of bone cement on coagulation functions following artificial hip joint replacement

Yin Jun-ping1, Guan Feng-ying2, Miao Hai-min3, Qiao Guo-yong4   

  1. 1 Department of Clinical Laboratory, General Hospital of Handan Administrative Bureau for Mining, Handan   056002, Hebei Province, China; 2 Department of Clinical Laboratory, First Hospital of Handan, Handan   056002, Hebei Province, China; 3 Operating Room, Handan Hospital of Traditional Chinese Medicine Handan   056002, Hebei Province, China; 4 Second Department of Orthopaedics, Affiliated Hospital of Hebei University of Engineering, Handan   056029, Hebei Province, China
  • Online:2010-06-18 Published:2010-06-18
  • Contact: Qiao Guo-yong, Master, Attending physician, Second Department of Orthopaedics, Affiliated Hospital, Hebei University of Engineering, Handan 056029, Hebei Province, China qiaoguoyong2008@126.com
  • About author:Yin Jun-ping, Laboratorian, Department of Clinical Laboratory of General Hospital of Handan Administrative Bureau for Mining, Handan 056002, Hebei Province, China

PDF

609

被引次数

17

摘要：

背景：对于人工髋关节置换的高龄患者，宜采用骨水泥固定假体，在骨水泥应用过程中，出现很多严重的并发症，但对患者凝血机制的影响报道不多。
目的：观察人工关节置换过程中充填骨水泥对患者凝血功能。
方法：对65例ASAⅡ-Ⅲ级人工关节置换术的患者进行回顾性病例分析，其中股骨颈骨折38例，37例股骨头坏死，术中髓腔扩髓完成后，分别在注入骨水泥前10 min，注入骨水泥后30 min，1，2及3 h检测患者凝血功能相关指标，包括血浆凝血酶原时间、活化的部分凝血活酶时间、凝血酶时间、纤维蛋白原、及血浆D-二聚体水平，并进行统计学分析。
结果与结论: 血浆凝血酶原时间、纤维蛋白原、及血浆D-二聚体含量4项指标在注入骨水泥后30 min、1，2 h与注入骨水泥前30 min相比较均有显著性差异(P < 0.05)。活化的部分凝血活酶时间、凝血酶时间在各时间点与注人骨水泥前比较均无显著性差异(P > 0.05)。3 h后骨水泥对这些指标的影响消除，24 h后凝血功能恢复正常。说明人工关节置换中充填骨水泥后3 h可致患者血液高凝状态，应引起重视。

关键词: 人工髋关节, 置换, 骨水泥, 凝血功能, 血液相容性

Abstract:

BACKGROUND: It is suitable to use bone cement to fix the prosthesis in eldly patients undergoing artificial hip joint replacement. There are many serious complications of using bone cement and little reports about the effects of bone cement on the coagulation functions of patients.
OBJECTIVE: To investigate the effect of bone cement on coagulation functions during the artificial joint replacement.
METHODS: Sixty-five patients scheduled for ASA Ⅱ-Ⅲ artificial joint elective replacement were investigated retrospectively. There were femoral neck fractures in 38 patients and femoral head necrosis in 37 patients. Blood samples were measured 10 minutes before and 30 minutes, 1, 2 and 3 hours after bone cement implantation. The parameters associated with coagulation functions were observed in all patients, including plasma prothrombin time, activated partial thromboplastin time, thrombin time, fibrinogen and D-dipolymer.
RESULTS AND CONCLUSION: There were significant differences in plasma prothrombin time, fibrinogen and D-dipolymer between bone cement preimplantation and 30 minutes, 1, 2 hours after bone cement implantation (P < 0.05), and no difference in activated partial thromboplastin time and thrombin time (P > 0.05). The changes vanished 3 hours after bone cement implantation. The coagulation functions recovered 24 hours later. Bone cement implantated for 3 hours can cause temporal hypercoagulabale state, which should be paid more attention.

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