在143,782名尾切除术患者的系统性葡萄糖皮质体暴露和术后感染风险-丹麦纵向全国性研究
Doruk Orgun1, Ask Tybjærg Nordestgaard2,3, Henrik Enghusen Poulsen4,5,6
1Center for Surgical Science, Department of Surgery, Zealand University Hospital Køge and Roskilde, Køge, Denmark. door@regionsjaelland.dk.
Langenbeck's archives of surgery
|March 28, 2024
概括
在手术前使用高剂量的皮质糖类药物会增加尾切除术后的感染风险,特别是在腹腔镜手术中. 每天服用≥5毫克普雷迪尼松相当剂的患者面临更高的手术后感染风险.
科学领域:
- 外科手术 手术手术
- 药理学 药理学是指药理学的学科.
- 传染性疾病 传染性疾病
背景情况:
- 已知葡萄糖皮质类药物会增加术后感染风险.
- 术前暴露于葡萄糖皮质激素对尾切除术结果的具体影响需要澄清.
- 调查开放式和腹腔镜尾切除术之间的差异影响至关重要.
研究的目的:
- 为了确定手术前的葡萄糖皮质激素暴露是否与尾切除术患者的手术后感染有关.
- 评估这种关联是否在开放式尾切除和腹腔镜尾切除之间有所不同.
主要方法:
- 丹麦全国性研究 (1996-2018) 尾切除患者.
- 定义高 (≥5毫克/天的普雷尼松等价物) 与没有/低 (<5毫克/天) 的手术前皮质糖类暴露.
- 计算了90天的累积发病率和经手术后感染的调整危险比率,使用倾向性比分对敏感性进行匹配.
主要成果:
- 包括143,782名患者; 7654人经历了90天内的感染.
- 高水平葡萄糖皮质激素暴露组的感染率为10.0%,而没有/低水平暴露组的感染率为5.3%.
- 对感染的调整后危险比为1.25整体,对于腹腔镜 (1.59),但不是开放的 (1.09) 尾切除术显著更高.
结论:
- 术前高剂量葡萄糖皮质体 (≥5毫克/天) 暴露与尾切除术中绝对感染风险的增加有关.
- 对于腹腔镜尾切除术而言,感染的相对风险显著增加,但对于开放尾切除术而言,并非如此.
- 这些发现表明一种特定于程序的相互作用,可能受到不同亚组的基线感染率的影响.
关键词:
脑下垂体脑下垂体上腺轴laparoscopic 尾切除术 拉巴洛斯科普的尾切除术是指用眼镜切除尾的切除术.全国范围的注册表研究.开放的尾切除术手术后感染 术后感染在手术前使用葡萄糖皮质类药物.更多相关视频
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