Hip Replacement Perioperative Cardiovascular Events Related Factors Analysis

Objective:This issue is studied retrospectively through the hip arthroplasty preoperative cardiovascular and cerebrovascular events records, searching the risk factors of cardiovascular and cerebrovascular events in the hip arthroplasty preoperative, and explore the treating potential diseases with Traditional Chinese Medicine on clinical guidance role in the prevention of perioperative cardiovascular and cerebrovascular events occur.Methods:Collected the medical records of hip replacement patients in the Wangjing Hospital of China Academy of Traditional Chinese Medicine for a total of142cases during the period from September2008to March2011, exclude records of24and selected medical records of118according to medical records by inclusion and exclusion criteria. Selected118cases,30cases of perioperative cardiovascular and cerebrovascular events as the case group, and the remaining88cases of hip replacement perioperative period did not occur cardiovascular and cerebrovascular events as a control group. General in the control group and case group, past medical history, relevant laboratory examination results and related indicators of perioperative univariate analysis of the48factors in advance, count the column chi-square test, t test measurement data to meet the normal distribution, does not meet the normal distribution line rank-sum test and stepwise multiple regression analysis, then the backward method of single-factor line where P≤0.05, and the regression equation.Results:1The cardiovascular and cerebrovascular event rate was25.42%, cardiovascular events accounted for16.10%and cerebrovascular events9.32%.2Hip replacement in peri operation period of TCM etiology and pathogenesis is divided into qi stagnation and blood stasis, liver and kidney deficiency, blood deficiency, phlegm and blood stasis, Yang deficiency and cold, cold and dampness.The most important type are stagnation of Qi and blood stasis and deficiency of liver and kidney.3Hip replacement in peri operation period of the Chinese medicine decoction using rate69.50%, cure is divided for promoting blood circulation and removing blood stasis, nourishing liver and kidney, replenishing qi and blood, phlegm, blood warm yang cold-dispelling, Qufeng desiccant, with promoting blood circulation by removing blood stasis and tonifying the liver and kidney mainly.4Univariate analysis showed that previous history of hypertension, coronary heart disease history, diabetes history, smoking history, postoperative anemia, postoperative hypoproteinemia, electrolyte imbalance after surgery, intraoperative blood transfusion, intraoperative blood transfusion, burglary whether high systolic blood pressure, burglary whether the relatively fast heart rate, oxygen saturation on the low side in a room, perioperative symptoms, and whether the use of traditional Chinese medicine, surgical reasons, cardiac function, age, burglary, systolic blood pressure, burglary, oxygen saturation19degree single factor in the case group and control group, P≤0.05, with statistical significance.5Statistically significant19factors line backwards method multiple stepwise regression analysis showed that preoperative symptoms, coronary heart disease history of postoperative anemia, the use of Chinese medicine, the six factors of age, burglary, and heart rate too fast in the case group and the control group, P≤0.05, statistically significant into the linear regression equation, the linear regression equation was Y (hip replacement surgery perioperative cardiovascular and cerebrovascular events)=0.152X2(coronary heart disease history)+0.132X5,(postoperative anemia)+0.139X9(burglary, heart rate too fast)-0.158X11(use of Chinese medicine)+0.540X12(perioperative symptoms)+0.005X18(age)-0.211.Conclusion:1Compared with other literature, this study for hip replacement patients with old age, underlying diseases and characteristics of the combined cardiovascular and cerebrovascular system. Cerebrovascular events was25.42%, the main symptoms of lacunar infarction; cardiovascular events was16.10%; mortality rate of2.54%.2Hip replacement in peri operation period of TCM etiology and pathogenesis in Qi stagnation and blood stasis and deficiency of liver and kidney. Peri operation period of the Chinese medicine decoction using rate69.50%, cure is divided for promoting blood circulation and removing blood stasis, nourishing liver and kidney, replenishing qi and blood, phlegm, blood warm yang cold-dispelling, Qufeng desiccant, class six, with promoting blood circulation by removing blood stasis and tonifying the liver and kidney mainly. Peri operation period differentiation using traditional Chinese medicine decoction can effectively prevent the occurrence of cardiovascular and cerebrovascular events.3Age≥75-year-old elderly, previous history of coronary heart disease, history of diabetes, hypertension, high-risk and very high-risk group, daily smoking>10or history of smoking>5years, preoperative cardiac function≥Class II factors for hip arthroplasty perioperative risk factors for cardiovascular and cerebrovascular events. Old age associated with coronary heart disease, or preoperative cardiac surgery within1year, with or without a clear history of heart disease echocardiography prompted heart have occurred in the organic changes, electrocardiogram prompted perioperative ST-T segment changes in patients with hip arthroplasty high risk of sudden cardiac death has occurred.4Perioperative period in patients with irritability, chest tightness, palpitations, chest pain, nausea and vomiting, speech and limb adverse discomfort, can effectively predict cardiovascular and cerebrovascular events.5High burglary systolic blood pressure, heart rate too fast, breaking out rooms peripheral blood oxygen saturation lower, burglary oxygen saturation lower, severe anemia after surgery, postoperative low albumin, and postoperative electrolyte imbalance and other factors are perioperative risk factors for cardiovascular and cerebrovascular events of the hip replacement surgery.