López-Durán L, García-López A, Durán L, Hurtado J, Ruiz C, Rodrigo J L
Orthopaedic Surgery and Traumatology Service, University Hospital San Carlos, Madrid.
Int Orthop. 1997;21(4):253-8. doi: 10.1007/s002640050161.
We report a prospective study of 30 patients who underwent total hip arthroplasty for osteoarthrosis in order to investigate the haemodynamic and respiratory changes which occur during operation. Cement was used in 17 cases and the implants were not cemented in 13. Pulmonary and cardiac function, blood levels of methylmethacrylate monomer, intramedullary pressure and transoesophageal echocardiography were recorded. Two well differentiated echogenic patterns appeared consistently during the operation. The intramedullary pressure became raised as the cement was inserted. The following changes occurred within seconds and continued for some minutes: elevation of mean arterial pressure and mean pulmonary artery pressure; decrease of arterial oxygen tension and of mixed venous PO2, and greater tissue consumption of oxygen. Although we recorded raised concentration of methylmethacrylate monomer in venous blood after the cement was inserted, there is no evidence that the monomer is responsible for the haemodynamic changes which take place.
我们报告了一项针对30例因骨关节炎接受全髋关节置换术患者的前瞻性研究，目的是调查手术过程中发生的血流动力学和呼吸变化。17例使用骨水泥，13例未使用骨水泥固定植入物。记录了肺和心脏功能、甲基丙烯酸甲酯单体的血液水平、髓内压力和经食管超声心动图。手术过程中始终出现两种明显不同的回声模式。插入骨水泥时髓内压力升高。在数秒内发生以下变化并持续数分钟：平均动脉压和平均肺动脉压升高；动脉血氧张力和混合静脉血氧分压降低，以及组织耗氧量增加。尽管我们记录到插入骨水泥后静脉血中甲基丙烯酸甲酯单体浓度升高，但没有证据表明单体是导致所发生血流动力学变化的原因。
