在接受脊椎手术的患者中,手术前的糖化血红蛋白度和早期的术后感染:系统性审查
Katarzyna Prus1, Başak Akça2, Federico Bilotta3
1Department of Neurology, Medical University of Lublin, Poland.
Clinical neurology and neurosurgery
|August 19, 2023
概括
在脊椎手术患者中,手术前血红蛋白A1c (HbA1c) 水平升高与早期术后感染风险增加有关. 常规的HbA1c测试可以改善患者的治疗结果和手术管理.
科学领域:
- 整形外科 整形外科 整形外科
- 传染性疾病 传染性疾病
- 内分泌学 在内分泌学.
背景情况:
- 手术后感染是脊柱手术患者的一个重大问题.
- 虽然葡萄糖代谢障碍是已知的危险因素,但手术前HbA1c与感染之间的具体联系尚未得到充分研究.
- 目前的指导方针缺乏在选择性脊柱手术前进行常规HbA1c测试的严格建议.
研究的目的:
- 系统地审查现有的临床证据,研究手术前HbA1c水平与脊柱手术后早期感染之间的关联.
- 综合有关手术前HbA1c对传染性和非传染性并发症以及患者长期结局的影响的数据.
主要方法:
- 使用PubMed和EMBASE数据库进行了系统审查.
- 搜索词包括"脊柱手术"",感染"和"HbA1c".
- 研究选择和报告遵循PRISMA指南,包括16项研究.
主要成果:
- 大多数包括在内的研究表明,在术前HbA1c度较高和术后感染风险增加之间存在显著的相关性.
- 升高的HbA1c也与非传染性并发症的发病率更高有关.
- 在手术前HbA1c水平较高的患者中,观察到未来患者结果更差的趋势.
结论:
- 手术前的HbA1c水平似乎是早期术后感染和其他脊柱手术并发症的重要预测因素.
- 需要进行进一步的精心设计的研究,采用适当的样本大小,以确认手术前HbA1c测试在优化患者管理中的作用.
- 常规的HbA1c查可能有助于识别接受选择性脊柱手术的风险患者.
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