髓内管冲洗能减少脂肪栓塞吗？一项经食管超声心动图的随机临床试验。

Does intramedullary canal irrigation reduce fat emboli? A randomized clinical trial with transesophageal echocardiography.

作者信息

Zhao Jiaqi, Zhang Jianquan, Ji Xiufeng, Li Xuemei, Qian Qirong, Xu Qi

机构信息

Department of Ultrasound, Changzheng Hospital, Second Military Medical University, Shanghai, China.

出版信息

J Arthroplasty. 2015 Mar;30(3):451-5. doi: 10.1016/j.arth.2014.10.006. Epub 2014 Oct 14.

DOI:10.1016/j.arth.2014.10.006

PMID:25458091

Abstract

The effect of medullary cavity irrigation on fat emboli during total knee arthroplasty (TKA) was evaluated. Thirty female patients with osteoarthritis were randomly assigned to undergo conventional TKA without irrigation (conventional group) or with medullary canal saline irrigation (irrigation group). The four-chamber view was monitored by transesophageal echocardiography (TEE) and echogenic reflections of fat emboli were observed. The grey-scale score and area ratio of fat emboli were calculated during TKA. Hemodynamic parameters were simultaneously monitored and showed no obvious change between two groups (P>0.05). The average grey-scale score (P=0.016) and area ratio (P=0.033) of emboli were significantly decreased in irrigation group. Removal of medullary contents by irrigation could significantly reduce the formation of fat emboli during TKA.

摘要

评估了全膝关节置换术（TKA）中髓腔冲洗对脂肪栓塞的影响。30例骨关节炎女性患者被随机分配接受不冲洗的传统TKA（传统组）或髓腔生理盐水冲洗（冲洗组）。通过经食管超声心动图（TEE）监测四腔心视图，并观察脂肪栓塞的回声反射。在TKA期间计算脂肪栓塞的灰度评分和面积比。同时监测血流动力学参数，两组之间无明显变化（P>0.05）。冲洗组栓子的平均灰度评分（P=0.016）和面积比（P=0.033）显著降低。冲洗去除髓腔内容物可显著减少TKA期间脂肪栓塞的形成。