Clinical Study Of Effection Of Bone Cement In Joint Arthroplasty Operation On Patients' Vital Sign And Blood Clotting Function

Objective:Study of the vital sign and coagulation functions impact of bone cement in the joint arthroplasty operation of older persons.To compare the different effects of bone cement on the vital sign in hip and knee joint arthroplasty and analyze a death case.Methods:Review the systolic blood pressure, diastolic blood pressure and heart rate changes before and after the use of bone cement in arthroplasty of femoral neck fracture of the 93 cases in 2005-2007 by use own matching T-test . The changes of blood pressure and heart rate were retrospectively analyzed in 93 THR and 64 TKR patients ,which used bone cement during 2000-2008. The patients age from 60 to 70. 10 patients admitted to our hospital between November 2007 and March 2009 involed in this study.There 3 males 7 females with the mean age of 65 years (ranged,55-82 years), including femoral neck fractures in 4 patients,and hip joint osteoarthritis in 4 patients,and proximal hmnerus fractures 2 patients. The relative parameters were observed in all patients including prothrombin time (PT), activated partial thromboplastin time (APPT),and fibrinogen(FIB).Blood samples were measured 5 min before,5 min after bone cement implatation. The data were analyzed by statistics. Results:There is a significant statistics difference in diastolic blood pressure and systolic blood pressure changes before and after the use of bone cement(P<0.05), systolic blood pressure average decrease 14.73 mmHg, diastolic blood pressure average decrease 7.69 mmHg. Here is no difference in heart rate(P>0.05),heart rate average decrease 1.11 per minute. There was significant difference of SBP of group A (general anesthesia )and B (extradural anaesthesia),but the DBP and HR was not significant difference of group A and group B . On the other hand ,there was significant difference of SBP and DBP in the group A and group B, there was not significant difference of the HR both A and B. Implantation of bone cement obviously infect SBP during operation of THR. PT significantly decreased at 5 min after bone cemnet implantation,compared with 5 min before implantation(P<0.05).FIB significantly increased at 5 min after implantation compared with 5 min before implantation (P<0.05). There was no significant difference in APTT before and after implantation.Conclusions:There is a significant decrease in diastolic blood pressure and systolic blood pressure after the use of bone cement in the arthroplasty operation of femoral neck fracture. Bone cement shows a tendency to activate blood coagulation, especially in elderly persons but the relative indexes are still in normal range.The author consider it is necessary to closely monitor blood pressure in the use of bone cement of arthroplasty. To give appropriate countermeasures and strictly improve the preoperative preparation will be effective measure to tackle the complication.