Clinical Effect Of Bushen Huoxue Decoction On The Prevention Of Bone Cement Implantation Syndrome In PKP

Objective:By observing the changes of hemodynamics and D-dimer before and after bone cement implantation in patients with osteoporotic vertebral compression fracture(OVCF)undergoing percutaneous kyphoplasty(PKP),the effectiveness of Bushen Huoxue Decoction in preventing bone cement implantation syndrome(BCIS)was confirmed.Methods:This study selected a total of 60 OVCF patients who underwent PKP treatment from April 2019 to January 2020 in the Orthopedic inpatient department of the Second Affiliated Hospital of Nanjing University of Traditional Chinese Medicine(Jiangsu Province Second Chinese Hospital),to surgical treatment in patients with in three days after admission,which are performed by the same group of Bone injury spine surgeon at the hospital.In the control group,the patient was admitted to the hospital for a definite diagnosis,followed by supine rest braking,oral administration of celecoxib 200 mg qd to relieve the pain,calcium carbonate D3 tablets 600mg qd Po,and salmon calcitonin 50IU qd im to prevent osteoporosis,improve the relevant preoperative examination to eliminate the contraindications.On the basis of this,the observation group was given 400ml of oral Bushen Huoxue Decoction in the morning and evening before surgery.Patients in both groups were in intraoperative real-time monitoring hemodynamics,and the scores of temporary symptoms during the operation were observed and recorded,as well as heart rate(HR)before bone cement injection(T0)and after injection of 1 min(T1),3 min(T2),5 min(T3),10 min(T4),invasive arterial systolic blood pressure(IASBP),invasive arterial diastolic blood pressure(IADBP),mean arterial pressure(MAP),and finger oxygen saturation(SPO2),arterial blood gas index at T0,T3,T4 and D-Dimer at preoperative,intraoperative T3.Finally collect,collate and statistical analysis results.Result:1.The difference between two groups was no statistical significance in HR,IASBP,IADBP,MAP,SPO2,arterial blood gas index and D-Dimer before the bone cement injection(P>0.05).2.All the patients in the two groups successfully completed the operation,with satisfactory efficacy,no leakage of vertebral canal bone cement and spinal cord compression,no serious complications such as myocardial infarction,heart and lung failure,and shock.The score of temporary symptoms in the observation group was better than that in the control group(P<0.05).3.Hemodynamic instability was observed in the two groups 1-5min(T1-T3)after bone cement injection,among which the heart rate increased and blood pressure decreased more significantly at 3 minutes(T2)after bone cement injection,and the comparison between the two groups was statistically significant(all P<0.05).The HR,IASBP,IADPP,and MAP indicators in the observation group fluctuated significantly less than the control group.Especially in the prevention of blood pressure drop,the observation group had a significant boosting effect,and the comparison between groups was statistically significant(P<0.05).4.SPO2 showed a downward trend after injection of bone cement in the two groups,and the decrease in the control group was statistically significant(P<0.05).SPO2 fluctuated little in the observation group,and the comparison of SPO2 between the two groups was statistically significant(P<0.05).Affected by painful stimuli,the two groups of patients did not develop hypoxemia and appear the phenomenon of high arterial oxygen,which was considered to be caused by hyperventilation due to stimulation,but the difference was not statistically significant(P>0.05).At 5 minutes(T3)after bone cement injection,the carbon dioxide partial pressure decreased,which was statistically significant(P<0.05).5.The D-Dimer index was increased in both groups,and the control group was significantly higher than before,which was statistically significant(P<0.05).In the observation group,D-Dimer also increased,but the degree of elevation was reduced by comparison.The comparison between the two groups was statistically significant at 5 minutes(T3)after bone cement injection(P<0.05).Conclusion:Bushen Huoxue Decoction can stabilize the hemodynamic changes during percutaneous kyphoplasty,relieve pain symptoms,improve the clotting state,and improve the safety of surgery to a certain extent,and provide a new idea for Chinese medicine to participate in the prevention of BCIS.