Gammer W, Bengtson A, Heideman M
Department of Orthopedic Surgery, Ludvika Hospital, Sweden.
Clin Orthop Relat Res. 1988 Nov(236):205-9.
Anaphylatoxins are released during total hip arthroplasties (THA) when methylmethacrylate is used. These toxins may be responsible for hemodynamic and pulmonary instability during surgery. Recent studies have shown that the release of anaphylatoxins may be inhibited by high-dose corticosteroids (HDC). In a double-blind study 30 consecutive patients with osteoarthritis or failed hip fractures were randomized into two groups; 15 patients received HDC at the beginning of the operation and 15 patients, designated the control group, received infused saline. Anaphylatoxin formation, arterial oxygen tension, and blood pressure were determined preoperatively, during the operation, and one day postoperatively. The patients who received HDC had no significant alteration regarding the anaphylatoxins or arterial oxygen tension during surgery. However, in the control group elevated C3a levels and decreased PaO2 levels were found. Corticosteroids therefore inhibit complement activation and anaphylatoxin release in hip arthroplasty surgery.
在使用甲基丙烯酸甲酯进行全髋关节置换术（THA）时会释放过敏毒素。这些毒素可能是手术期间血液动力学和肺部不稳定的原因。最近的研究表明，高剂量皮质类固醇（HDC）可能会抑制过敏毒素的释放。在一项双盲研究中，30例连续的骨关节炎或髋关节骨折失败患者被随机分为两组；15例患者在手术开始时接受HDC，15例患者作为对照组接受输注生理盐水。在术前、术中及术后一天测定过敏毒素形成、动脉血氧张力和血压。接受HDC的患者在手术期间过敏毒素或动脉血氧张力无显著变化。然而，在对照组中发现C3a水平升高和PaO2水平降低。因此，皮质类固醇在髋关节置换手术中可抑制补体激活和过敏毒素释放。
