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手术前营养影响 关节镜旋转手套修复后的复发率
Hitoshi Shitara1, Tsuyoshi Ichinose, Tsuyoshi Sasaki
1Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.
The Journal of bone and joint surgery. American volume
|August 30, 2024
概括
低老年营养风险指数 (GNRI) 表示的手术前营养状况不佳,是老年人关节镜旋转手套修复 (ARCR) 后旋转手套复发的重要危险因素. 低于103的GNRI得分表明风险增加.
科学领域:
- 整形外科手术 整形外科手术
- 老年医学 老年医学
- 营养科学 营养科学
背景情况:
- 关节镜旋转手套修复 (ARCR) 后旋转手套的复发是一个临床问题,特别是在老年患者中.
- 影响痕风险的术前因素对于干预至关重要,但很少有可以修改的因素.
- 研究术前营养状况与术后发病率之间的联系至关重要.
研究的目的:
- 确定老年营养风险指数 (GNRI) 评估的手术前营养状况与65岁及以上患者在ARCR后旋转手腕复发的发生之间的关联.
- 确定再撕裂的独立风险因素,包括营养状况和撕裂特征.
主要方法:
- 一个单一中心的回顾性研究,涉及143名接受ARCR的患者 (≥65岁).
- 使用老年营养风险指数 (GNRI) 评估术前营养状况.
- 后勤回归分析以确定复发的独立风险因素,复发经过2年的术后MRI证实.
主要成果:
- 整体留学率为20.3%.
- 在 retear 组中观察到较低的白蛋白水平,GNRI 和术后肩部强度.
- 再撕裂的独立风险因素包括低GNRI (odds比率[OR],3.39) 和中侧撕裂大小增加 (OR = 1.10).
- 确定GNRI切线为103,GNRI<103显著增加了复发风险 (OR=3.88至5.62).
结论:
- 老年人营养风险指数 (GNRI) 值为103或更高,可能表明手术前营养状况充足,可能降低ARCR后旋转手臂裂风险.
- 需要进一步的研究来证实这种营养值的临床意义.
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