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术后全关节整形术的结果:一个案例系列
Hannah Kenneally1, Nicholas Brown2, Daniel Schmitt2
1Loyola University Chicago Stritch School of Medicine, Maywood, IL, USA.
整体关节整形术 (TJA) 是安全的,对于患有骨的患者. 仔细管理胃肠道 (GI) 问题,如腹或便秘是TJA手术后成功的关键.
科学领域:
- 外科手术的结果
- 关节质整术是指关节质整术.
- 胃肠病学 胃肠病学
背景情况:
- 整形关节整形术 (TJA) 存在理论上的风险,包括营养影响,胃肠道 (GI) 并发症 (阻塞,便秘,腹) 和感染风险.
- 人们担心口腔术对患者营养的潜在负面影响,以及对胃肠道问题的敏感性增加,特别是在使用阿片类药物时.
- 骨切割的开放性质引发了对后续手术中感染风险的理论担忧.
研究的目的:
- 报告结局,并评估在有肠道骨病史的患者中进行全关节整形术 (TJA) 的风险.
- 评估TJA在瘤患者群体中的安全性和有效性.
主要方法:
- 追溯的病例系列的患者接受了全关节或全膝关节关节整形手术 (TJA),有史以来的骨干.
- 包括10名患者中的14例病例,检查了个别的TJA和 ostomy手术细节和结果.
主要成果:
- 在TJA之前,没有患者需要专门的胃肠道清除或除标准抗生素之外的预防.
- 所有的TJA程序都取得了良好的结果.
- 四例 (29%) 患有并发症:2例与胃肠道相关 (胃肠道输出改变,通过补水和药物调整进行管理) 和2例非胃肠道 (尿路感染,同期). 没有一个是危及生命的或需要重新手术的.
结论:
- 整体关节整形手术 (TJA) 可以安全地在患有骨的患者中进行.
- 对于 ostomy 患者的 TJA 的关键考虑因素包括管理潜在的术后腹或便秘.
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