Clinical Study On The Bone Cement Implantation Syndrome In Hip Arthroplasty

Objective: Bone cement type artificial hip replacement is an effectiveoperation for treatment of Senile Osteoarthritis of the hip and hipfractures and other diseases, patients can be more early functionalexercise,in order to reduce the complication of long-term bed rest,improve patient quality of life. But the bone cement type artif. But thebone cement type artificial hip replacement operation risks andcomplications are also many, the bone cement implantation syndrome is acommon complication of the operation, it is shown as: transienthypotension, hypoxia, arrhythmia, pulmonary arterial pressure,pulmonary fat embolism, bleeding (coagulopathy), asthma attacks,serious BCIS can lead to intraoperative cardiac respiratory arrest, suddendeath. To prevent the occurrence of BCIS is at present, one of the mostpressing clinical problem.Through the retrospective analysis of the clinical data of bone cementtype artificial hip replacement patients in recent1years in China JapanUnion Hospital of Jilin University Department of joint surgery of theDepartment of orthopedics, statistical description of the clinical data ofthe patients, and further explore the high risk factors of BCIS andapplication of methylprednisolone to prevent the occurrence of BCIS role,provides the reference for the clinical treatment. Method: Retrospective analysis of2013January to2013Decemberin Department of orthopedics, China Japan Union Hospital of JilinUniversity11floor joint surgery hospital and accepted clinical data ofbone cement type artificial hip joint replacement patients, were collectedfrom medical records of97cases, including27cases of male, female70cases. The medical records were obtained each physiological index ofpatients, record the statistical indicators and the establishment of adatabase: diagnosis,gender, age, past history, operation mode, ASAanesthesia risk classification, anesthesia, bone cement type, whether JiaQianglong (intravenous methylprednisolone dose and givenmethylprednisolone and bone cement implantation time interval) the totalamount of infusion, surgery. According to whether the BCIS patientswere divided into two groups, the differences of the two groups werecompared. The use of statistical software SPSS20.0statistical processing,continuous variables using the t test, categorical variables using twoindependent group χ2test, and draws the corresponding statistic and Pvalue. P <0.05considered significant between group differences havestatistical significance.Results:97patients were included in the study of some important results:the average age of patients was76.54±11.02(53～104) years old,women accounted for72.16%, femoral neck and intertrochanteric fractureaccounted for72.16%of cases, surgery is the main implementation of artificial femoral head replacement (70.10%). BCIS occurred in97patients of the37cases, the incidence rate was38.14%; among them theserious BCIS3patients, The death of2cases, the incidence rate was2.06%. According to whether the BCIS patients were divided into twogroups, the results show the comparison between two groups, patientswith diabetes, coronary heart disease, hypertension, pulmonary infectionrate of BCIS showed significant difference (p=0.0004); prophylacticapplication of methylprednisolone group and no prevention of BCISbetween the treatment group differences in the incidence of showedsignificant (p=0.01).Conclusion:(1) underwent cemented hip replacement were mostlyelderly women, the main reason is to hospital for treatment of femoralneck and intertrochanteric fracture of the femur, the implementation ofthe operation for the artificial femoral head replacement;(2) preoperativecoronary heart disease, hypertension, diabetes, lung infection and otherdiseases important factors associated with increased risk of BCIS, pleaseconsultations given symptomatic treatment recommendations beforesurgery, the disease control and operation treatment in a relatively stablestate;(3) bone cement implantation before0～40min prophylactic use ofmethylprednisolone (40～500mg) can significantly reduce the incidenceof BCIS in patients with.