术前皮质类固醇对术后葡萄糖控制在全关节关节整形术中的影响
Steven Denyer1, Abhishek Ramini1, Carlo Eikani1
1Department of Orthopaedic Surgery and Rehabilitation, Loyola University Medical Center, Stritch School of Medicine, Maywood, IL, USA.
Arthroplasty today
|December 11, 2023
概括
在全关节整形术 (TJA) 后治疗术后恶心和吐的德克萨米他并没有使糖尿病或非糖尿病患者的血糖控制或并发症恶化. 它还减少了一些患者的住院和ICU入院.
科学领域:
- 整形外科手术 整形外科手术
- 麻醉学 麻醉学
- 内分泌学 在内分泌学.
背景情况:
- 德克萨米他经常用于预防手术后恶心和吐 (PONV) 在全关节整形术 (TJA) 后.
- 有关德克萨米他诱导高血糖的潜力存在担忧.
- 这项研究评估了德克萨米他对TJA患者葡萄糖水平和并发症的影响.
研究的目的:
- 评估手术前甲松对术后葡萄糖水平和TJA患者的可变性的影响.
- 为了确定德克萨米他是否会影响TJA的糖尿病和非糖尿病患者的并发症率.
- 在TJA血糖控制的背景下调查德克萨米松的安全性和有效性.
主要方法:
- 1928年接受初级全膝关节和关节整形手术的患者的回顾性审查.
- 根据手术前的德克萨米他给药情况,患者被分类为不同组.
- 分析包括术后血糖测量,并发症数据和统计建模 (逻辑回归,负二项回归).
主要成果:
- 在糖尿病或非糖尿病患者中,手术前的德克萨米他并没有显著改变平均葡萄糖,禁食葡萄糖或葡萄糖变异性.
- 接受德甲的非糖尿病患者的ICU入院率显著降低 (P < .01).
- 接受德克萨米他的患者在医院住院时间显著缩短 (P < .001).
结论:
- 在TJA患者的PONV预防中,手术前的德克萨米他是安全有效的,无论糖尿病状况如何.
- 德克萨米他不会对葡萄糖水平,可变性或感染率产生不利影响.
- 德克萨米他的使用与手术后住院时间的缩短有关.
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