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1、骨水泥在人工髋关节置换术中的应用,themegallery,实习二组 李娜,Contents,概 述,骨水泥是一种用于骨科手术的医用材料，由于它的部分物理性质以及凝固后外观和性状颇像建筑、装修用的白水泥，便有了如此通俗的名称。其实，它的正名是骨粘固剂。其主要成分是聚甲基丙烯酸甲酯，主要用于人工关节置换手术。,Image information in product-Title Image ilikeclick.co.kr-CD:medical perspectives(Eyewire)-Note to customers:This image has been licensed to be u
2、sed within this PowerPoint template only.You may not extract the image for any other use.,使用方法,骨水泥的优点,骨水泥的缺点,骨水泥植入综合征,机 制（一）,骨水泥为高分子聚合物，化学成分为聚甲基丙烯酸甲酯(PMMA)，术中临时调制，由液态单体(LMMA)在聚合酶粉剂催化下聚合而成。,Image information in product-Title Image ilikeclick.co.kr-CD:medical perspectives(Eyewire)-Note to customers:Th
3、is image has been licensed to be used within this PowerPoint template only.You may not extract the image for any other use.,机 制（二）,LMMA可渗透入血，高浓度LMMA有心肌抑制作用，可破坏粒细胞、单核细胞和内皮细胞使之释放蛋白水解酶，引发细胞和组织溶解，同时可激活补体系统，增加细胞因子产生和释放，使凝血活动增强，还可作用于血管平滑肌之钙通道，导致血管扩张，血压下降。,Image information in product-Title Image ilikeclic
4、k.co.kr-CD:medical perspectives(Eyewire)-Note to customers:This image has been licensed to be used within this PowerPoint template only.You may not extract the image for any other use.,机 制（三）,低粘度骨水泥和加压注入固定技术会在股骨髓腔内造成极高的髓内压，超过静脉循环压力时可破坏髓内静脉，骨髓、脂肪、骨颗粒等通过破坏的静脉进入循环系统，重者形成肺栓塞，使肺血管阻力升高、肺动脉高压、心肺功能衰竭。,Image
5、 information in product-Title Image ilikeclick.co.kr-CD:medical perspectives(Eyewire)-Note to customers:This image has been licensed to be used within this PowerPoint template only.You may not extract the image for any other use.,术前准备,术中护理（一）,1、妥善安置手术体位：患者侧卧90，患侧在上。2、严密观察患者的血液循环，皮肤颜色、弹 性、张力等。3、注意为患者
6、保暖：保持手术问温度在2426，不过多暴露躯体。,Image information in product-Title Image ilikeclick.co.kr-CD:medical perspectives(Eyewire)-Note to customers:This image has been licensed to be used within this PowerPoint template only.You may not extract the image for any other use.,术中护理（二）,4、在植入骨水泥时要密切观察心率、血压、呼吸的变化，如有变化应及
7、时配合麻醉师 进行抢救。常规配备阿托品、麻黄素、肾 上腺素、多巴胺等药品备用。,Image information in product-Title Image ilikeclick.co.kr-CD:medical perspectives(Eyewire)-Note to customers:This image has been licensed to be used within this PowerPoint template only.You may not extract the image for any other use.,术中护理（三）,5、在调配骨水泥时，尽量减少单体的
8、产生和空气进 入，防止骨水泥植入综合征的发生。6、假体植入前，髓腔用加有抗生素的生理盐水进行 脉冲式灌洗(500ml生理盐水+庆大霉素32万U)，然后用纱布擦干髓腔和假体柄，假体植入后及时 清除溢出髓腔的骨水泥。,Image information in product-Title Image ilikeclick.co.kr-CD:medical perspectives(Eyewire)-Note to customers:This image has been licensed to be used within this PowerPoint template only.You may
9、 not extract the image for any other use.,术后护理,骨水泥的远期并发症有待于进一步研究，应用现代骨水泥技术及术中预防性给药等措施可预防或减少术中骨水泥反应的发生。,Image information in product-Title Image ilikeclick.co.kr-CD:medical perspectives(Eyewire)-Note to customers:This image has been licensed to be used within this PowerPoint template only.You may not extract the image for any other use.,themegallery,Thank You!,
