经外科手术期间的血糖变化影响感染率在修复部和膝关节关节整形术后不同
Michael M Kheir1, Christopher G Anderson2, Yu-Fen Chiu3
1Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan.
The Journal of arthroplasty
|October 5, 2024
概括
手术后的血糖变异性没有预测关节修复手术后的周围假肢关节感染 (PJI),尽管体重指数是关键因素. 糖尿病患者在修复膝盖手术后仍有更高的PJI风险,无论血糖控制如何.
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.
- 传染病 传染病 传染病 传染病
背景情况:
- 术后血糖异常与全关节整形术后的不良事件有关.
- 这项研究调查了在无菌修复全关节关节整形术后高血糖,血糖变异性和周围假肢关节感染 (PJI) 之间的关联.
研究的目的:
- 为了确定术后高血糖和血糖变化是否与PJI相关,在无菌修复整关节节塑性术后两年内.
- 在修复部和膝盖关节整形术患者中识别PJI的风险因素.
主要方法:
- 对2,208名接受无菌修复全关节关节整形手术 (2012-2019) 的患者进行了回顾性审查.
- 术后葡萄糖值和血糖变异性的分析,使用变化系数,血糖偏差的平均幅度和J指数.
- 后勤回归分析以评估90天,1年和2年的随访时与PJI的关联.
主要成果:
- 在修订部中,只有血糖外游的平均幅度预测了一年后的PJI (P=0.045);身体质量指数与PJI一致相关.
- 在修订膝盖中,血糖指标与PJI无关,但在所有时间点 (P<0.05) 中,糖尿病人和非糖尿病人之间,PJI率有显著差异.
结论:
- 降低手术前的身体质量指数和术后的血糖变化可能会降低修复部手术中的PJI率.
- 糖尿病患者在修复膝关节手术后存在持续较高的PJI风险,无论手术前的葡萄糖管理如何.
相关概念视频
01:23Peripheral Artery Disease V: Postoperative Nursing Management
4
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
4
01:22Aneurysm IV: Nursing Management
3
Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
3
01:16Kidney Transplant III: Nursing Management
3
Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
3