骨凝固高凝血综合征:病理生理学,死亡率和预防
Ola E Dahl1,2, Are Hugo Pripp3, Mark Jaradeh4
1Centre of Medical Science, Education, and Innovation, Innlandet Hospital Trust, Brumunddal, Norway.
概括
在关节置换中使用的骨水泥可能会导致致命的心肺和血管问题,原因是有毒物质和细胞损伤. 这会导致血栓和器官损伤,特别是在老年患者中.
科学领域:
- 生物材料科学 生物材料科学
- 整形外科手术 整形外科手术
- 心血管生理学心血管生理学
背景情况:
- 在20世纪50年代引入用于关节假肢的烯酸骨水泥,已与外科手术期间的心脏呼吸和血管并发症有关.
- 涉及骨髓损伤和甲基甲基酸盐释放的手术程序触发神经刺激和凝血激活.
研究的目的:
- 阐明与骨水泥植入相关的致命心肺和血管功能障碍背后的病理生理机制.
- 确定有毒物质和血管活性化合物在水泥引起的并发症中的作用.
主要方法:
- 对研究骨水泥影响的人类和动物研究的综述.
- 在肺微循环中分析细胞碎片和激活细胞.
- 对凝血激活和血管活性物质释放的评估.
主要成果:
- 骨质水泥成分导致细胞破坏并激活凝血,导致肺微循环封存.
- 肺循环中的高凝血状态可能导致动脉血栓栓塞和器官损伤 (大脑,心脏,脏).
- 血管活性物质的释放有助于血液动力学失衡和潜在的致命结果.
结论:
- 破坏性结果的主要驱动因素是大量的凝血激活和细胞破坏从固化骨质水泥和释放的血管活性物质.
- 易受感染的人群,如患有关节骨折的老年患者,患上这些并发症的风险更高.
- 了解这些机制对于减轻在骨科手术中使用骨水泥相关的风险至关重要.
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