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犬全髋关节置换术麻醉期间心肺变量及血小板计数的变化

Changes in cardiopulmonary variables and platelet count during anesthesia for total hip replacement in dogs.

作者信息

Otto K, Matis U

机构信息

Department of Veterinary Surgery, Ludwigs-Maximilians-Universität München, Germany.

出版信息

Vet Surg. 1994 Jul-Aug;23(4):266-73. doi: 10.1111/j.1532-950x.1994.tb00481.x.

DOI:10.1111/j.1532-950x.1994.tb00481.x
PMID:8091629
Abstract

Changes in cardiopulmonary function and platelet count were determined in 22 dogs of various breeds that underwent total hip replacement with cemented femoral prostheses. In 11 dogs (group I) polymethylmethacrylate (PMMA) was inserted without venting the reamed and lavaged femoral canal. In a second group of 11 dogs (group II) a urethral catheter (ID: approximately 2.7 mm) was placed into the medullary cavity before the insertion of PMMA. The application of PMMA resulted in a decrease in end-tidal carbon dioxide tension (PETCO2) until 5 minutes after insertion of bone cement. Increases in arterial to end-tidal pCO2 gradient [P(a-ET)CO2] and physiological dead space (VD/VT) were recorded between 2 minutes before and 5 minutes after insertion of PMMA in 12 dogs. A significant decrease in platelet count occurred in both groups of dogs. Decreases in arterial pO2 (PaO2), arterial/alveolar oxygen tension ratio (PaO2/PAO2), and percent O2 saturation of hemoglobin in arterial blood (SaO2) were not statistically significant. No significant differences could be detected between data obtained from both groups of dogs. An increase in femoral intramedullary pressure caused by the insertion of PMMA and subsequent pulmonary microembolism by medullary contents has been considered the most likely cause for changes in pulmonary function. The lack of statistically significant differences in cardiopulmonary variables and platelet count between the two groups of dogs could have been related to inefficient pressure reduction by the method used.

摘要

对22只接受骨水泥型股骨假体全髋关节置换术的不同品种犬的心肺功能和血小板计数变化进行了测定。11只犬(第一组)在未对扩髓和冲洗后的股骨髓腔进行排气的情况下植入聚甲基丙烯酸甲酯(PMMA)。在另一组11只犬(第二组)中,在植入PMMA前将一根尿道导管(内径:约2.7 mm)置入髓腔。PMMA的应用导致呼气末二氧化碳分压(PETCO2)降低,直至骨水泥植入后5分钟。在12只犬中,记录到在植入PMMA前2分钟至植入后5分钟期间动脉血与呼气末二氧化碳分压梯度[P(a - ET)CO2]和生理死腔(VD/VT)增加。两组犬的血小板计数均显著下降。动脉血氧分压(PaO2)、动脉血氧分压与肺泡氧分压比值(PaO2/PAO2)以及动脉血中血红蛋白氧饱和度百分比(SaO2)的下降无统计学意义。两组犬的数据之间未检测到显著差异。PMMA植入导致的股骨髓内压升高以及随后髓腔内物质引起的肺微栓塞被认为是肺功能变化的最可能原因。两组犬在心肺变量和血小板计数方面缺乏统计学显著差异可能与所用方法减压效果不佳有关。

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