氢化泼尼松联合小剂量麻黄碱在预防骨水泥植入综合征中的应用

Application of Prednisolone Combined with Low-dose Ephedrine in the Prevention of Bone Cement Implantation Syndrome

目的:观察氢化泼尼松联合小剂量麻黄碱预防骨水泥植入综合征的效果,以期找到简单有效的减小骨水泥毒性的方法。方法:择期行髋关节置换手术的患者40例,随机分为两组(n=20):A组在骨水泥植入前预防性应用氢化泼尼松0.5 mg·kg^(-1)和麻黄碱5 mg;B组注入0.9%氯化钠注射液3 ml。记录麻醉前、骨水泥植入即刻、骨水泥植入后3,5,10,30 min等各个阶段的血压、心率、血氧饱和度。结果:与麻醉前相比,B组的收缩压和舒张压在骨水泥植入即刻、骨水泥植入后3,5 min均出现明显下降、心率均明显增快(P<0.01);与A组相比,B组在骨水泥植入即刻、骨水泥植入后3,5 min出现了更为明显的血压下降(P<0.05)。结论:在植入骨水泥以前预防性应用氢化泼尼松联合小剂量麻黄碱能显著减少手术过程中的血流动力学波动。

Objective ： To investigate the effect of prednisolone combined with low-dose ephedrine in the prevention of bone cement implantation syndrome in order to find a simple and effective method for reducing toxicity of bone cement. Method： 40 patients with hip-joint replacement surgery were randomly divided into two groups （n = 20） ： group A was with prophylactic use of prednisolone 0. 5 mg·kg^- 1 and ephedrine 5mg before the implantation of bone cement, and group B was used as the control group. Blood pressure, heart rate and blood oxygen saturation before the anesthesia and at 0,3,5,10 and 30 min after the bone cement implantation were recorded. Result： Compared with those before anesthesia, the systolic and diastolic blood pressure of group B was declined immediately while heart rate was significantly increased at 0,3 and 5min after the bone cement implantation （P 〈 0. 01 ）. Compared with that of group A, blood pressure of group B showed more notable decrease at 0,3 and 5 min after the bone cement implantation （ P 〈 0. 05 ）. Conclusion： Prophylactic use of prednisolone with low-dose ephedrine before the bone cement implantation can significantly reduce hemodynamic fluctuation during the surgery.