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目的探讨人工髋关节置换术后脑梗死的发生因素,分析其防治措施,以减少人工髋关节置换术后脑梗死发生几率。方法 722例人工髋关节置换术治疗的患者,其中2例患者术后明确诊断为脑梗死,回顾性分析患者的临床资料,查阅相关文献,总结脑梗死的发生因素及防治措施。结果并发症均发生于术后2~5 d,早期表现为头晕、乏力、嗜睡、睡眠时出现熟声,继而出现肢体麻木、失语、意识障碍、肢体力量减弱及消失等。2例均为男性患者,年龄为56~67岁;其中1例体型明显肥胖,患者分别使用骨水泥型人工关节及生物型人工关节,术前给予血脂检查,患者未查及明显高脂血症,凝血因子未见明显异常改变,双下肢动静脉彩超提示:双下肢动脉无明显斑块形成,无明显静脉闭塞症。颈动脉彩超未查。全部病例及时发现,请相关科室会诊,并做出正确处理,但2例患者住院期间均延长,1例痊愈出院,1例出院时仍有左侧肢体偏瘫,转入康复科进行进一步治疗。结论对人工髋关节置换术患者术前术后给予有效干预,可大大降低术后脑梗死发生几率。
Objective To investigate the causes of cerebral infarction after artificial hip replacement and to analyze its prevention and treatment measures to reduce the incidence of cerebral infarction after total hip arthroplasty. Methods A total of 722 patients undergoing total hip arthroplasty were enrolled. Two of them were diagnosed as cerebral infarction postoperatively. The clinical data of the patients were retrospectively analyzed. Relevant literatures were reviewed and the causes of cerebral infarction were summarized. Results Complications occurred in 2 ~ 5 days postoperatively. The early symptoms were dizziness, fatigue, drowsiness, familiar sound during sleep, followed by limb numbness, aphasia, disturbance of consciousness, loss of limb strength and disappearance. 2 cases were male patients, aged 56 to 67 years old; 1 case of obesity was obese, patients were used cemented artificial joints and biological artificial joints, preoperative blood lipids examination, the patient did not check and significant hyperlipidemia , Coagulation factors no significant abnormal changes in both lower extremity arteriovenous ultrasound Tip: no lower extremity artery plaque formation, no obvious venous occlusive disease. Carotid ultrasound was not checked. All cases were found in time, please consult the relevant departments and make the correct treatment, but 2 patients were hospitalized during the period were extended, 1 patient discharged, 1 left body left hemiplegia was discharged, transferred to the rehabilitation department for further treatment. Conclusion Effective intervention before and after artificial hip arthroplasty can greatly reduce the incidence of postoperative cerebral infarction.