椎体成形术骨水泥聚合温度变化实验的研究.docVIP

椎体成形术骨水泥聚合温度变化实验研究 柯珍勇 邓忠良 黄朝梁 周言忠 重庆医科大学附属第二医院骨科 400010 [摘要]目的 探讨经皮穿刺椎体成形术骨水泥聚合时温度的变化。方法 模拟人体环境，在37℃水浴环境中，观测5ml骨水泥球（palamed）共5个，聚合时中心温度及距表面5mm处温度变化，尸体椎体标本5个（骨质疏松椎体）内注射骨水泥5ml，37水浴环境下测 量骨水泥中心温度变化。结果 骨水泥球中心温度，最高温度63~65.4℃， 50℃以上持续时间66-73秒；距表面5mm处最高温度52.2-56.3℃，50℃以上持续时间28-33秒；椎体内骨水泥中心温度最高42~46℃。结论 在摸拟人体环境下，骨水泥聚合时所产生温度上升与其它体外实验相比，最高温度较低及 50℃以上持续时间短，在椎体成形术中不会出现聚合产热对周围组织造成热损伤。 [关键词] 骨水泥 温度 椎体成形术 骨质疏松 Experiment study on temperature measurement during polymerization of bone cement in vertebroplasty Ke zhen-yong, Den zhong-Liang, Huang Chao-Liang, et al Department of orthopedics, second college of clinical medicine, chong Qing medical university. 400010 [Abstract] Objective: To explore the transformation of temperature during polymerization of bone cement in vertebroplasty. Method: Imitate environment of human body, and five vertebral body, temperature was measured with five 5ml bone cement ball and five vertebral body with 5ml done cement injection, both were placed in a bath (37℃). Result: the peak temperatures in cement ball center were 63.1~65.4℃, the time above 50 degrees C were for 66~73 second, and away from ball face 5mm peak temperatures were 42~56.3℃. the time above 50℃ was for 28~30 second. The center temperature in vertebral body was 42~46℃ Conclusion: The peak temperature was lower and the time above 50℃ was shorter in imitated environment. There was no thermal damage during polymerization in vertebroplasty. [Key words] Bone cement; Temperature; Vertebroplasty; Osteoporosis. 经皮穿刺椎体成形术（Percutaneous vertebroplasty, pvp）已越来广泛用于骨质疏松压缩骨折，原发性和继发性椎体肿瘤的治疗,[1-5]它是通过向椎体内注射骨水泥甲基丙烯酸甲酯（polymethylmethacrylate, PMMA）强化椎体，从而达到支撑、止痛、稳定脊柱的目的。PMMA聚合时的产热是否会对周围组织造成热损伤，一直受到人们的重视[6,7]，为此我们摸拟人体环境，观察PMMA聚合时产热的变化。 一、材料与方法 1．温度观测系统及骨水泥材料 使用重庆大学智能化研究所研制的热电偶型温度控测仪，由温度传感穿刺针，信号转换器，计算机系统组成，可同步显示针尖传感器所测部位的温度，精确度0.1℃，信号采集频率为1Hz；骨水泥采用Palamed 骨水泥，椎体注射采用自制螺旋加压注射器。 2．骨水泥球的制作 骨水泥的注射，温度测量 Palamed 骨水泥，按骨水泥5ml，单体3ml，硫酸钡1ml为比例调匀，制成直径2.2