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目的观察椎体成形术中聚甲基丙烯酸甲酯(PMMA)静脉渗漏造成肺栓塞的严重程度与漏入量的关系。方法15只成年家犬随机分为A、B、C三组,静脉麻醉后分别经股静脉注入PMMA骨水泥0.5、1.0、2.0ml;于注入前、后行胸部CT平扫、肺动脉造影,测肺动脉压,行血气分析,于术后2h处死实验犬行病理检查。结果C组氧分压在注入PMMA骨水泥10min后显著下降,二氧化碳分压在注入1min后显著上升;B、C组平均肺动脉压在注入1min、10min时显著上升,差异均有统计学意义(P<0.05);其余各组间差异无统计学意义(P>0.05)。结论PMMA进入下腔静脉导致肺栓塞的严重程度可能与漏入量有关,椎体成形术中大剂量的渗漏可导致呼吸功能障碍。
Objective To observe the relationship between the severity of pulmonary embolism and leakage caused by venous leakage of polymethylmethacrylate (PMMA) during vertebroplasty. Methods Fifteen adult dogs were randomly divided into three groups (A, B and C). After intravenous anesthesia, 0.5, 1.0 and 2.0 ml PMMA bone cement were injected through the femoral vein respectively. Thorax CT scan and pulmonary angiography were performed before and after injection Pulmonary arterial pressure, line blood gas analysis, 2h postoperative death of experimental dogs pathological examination. Results The partial pressure of oxygen in group C decreased significantly 10 min after injection of PMMA bone cement, and the partial pressure of carbon dioxide increased significantly 1 min after injection. The average pulmonary arterial pressure in groups B and C increased significantly at 1 min and 10 min, with significant difference (P <0.05). There was no significant difference among the other groups (P> 0.05). Conclusions The severity of pulmonary embolism caused by PMMA into the inferior vena cava may be related to the amount of leakage. The large amount of leakage during vertebroplasty may lead to respiratory dysfunction.