升高的血红蛋白A1c和手术后并发症的风险在选手和上肢手术中
Cameron T Cox1, Stephen Sierra1, Alec Egan1
1Orthopedic Surgery, Texas Tech University Health Sciences Center, Lubbock, USA.
Cureus
|December 7, 2023
概括
在糖尿病患者中,高血红蛋白A1c (HbA1c) 水平 (>10%) 显著增加手和上肢手术的手术并发症风险. 血糖控制,而不仅仅是诊断出糖尿病,是手术准备的关键.
科学领域:
- 整形外科手术 整形外科手术
- 内分泌学 在内分泌学.
- 手术结果研究研究.
背景情况:
- 血红蛋白A1c (HbA1c) 在预测手术并发症中的实用性显示出混合的结果.
- 外科医生经常使用 HbA1c 切断值来确定选择性手术的资格.
- 关于HbA1c作为选择性手和上肢手术的风险因素的数据有限.
研究的目的:
- 评估HbA1c水平升高与手术后并发症在选手和上肢手术中的相关性.
- 为了确定HbA1c水平是否会影响糖尿病诊断之外的外科手术风险.
主要方法:
- 对930个可选手和上肢手术的回顾性图表审查.
- 对334名患者的分析,记录了HbA1c水平 (手术前或术后).
- 使用费舍尔精确测试,绝对风险,赔率比率和回归分析进行统计评估.
主要成果:
- 单独的糖尿病并没有与术后并发症的增加有关.
- 糖尿病患者的HbA1c> 10%具有明显更高的绝对并发症风险.
- 糖尿病患者的HbA1c水平在6.5%至10%之间,并没有显著提高并发症的几率.
结论:
- 用HbA1c表示的血糖控制应该是外科准备算法的一部分.
- HbA1c水平不应成为选择手和上肢手术的独立失格因素.
- 对血糖控制的个性化评估对于手术风险分层至关重要.
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