患有糖尿病的人在白内障手术后患上术后内炎的风险更高吗? 一个系统的审查和元分析
Kai-Yang Chen1, Hoi-Chun Chan2, Chi-Ming Chan3,4
1School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
Journal of ophthalmic inflammation and infection
|March 12, 2025
概括
糖尿病患者在白内障手术后患上术后内炎 (POE) 和后破裂 (PCR) 的风险更高. 抗生素的使用显著降低了所有患者的POE风险.
科学领域:
- 眼科医生 眼科 眼科
- 糖尿病学 糖尿病学
- 公共卫生 公共卫生
背景情况:
- 手术后内炎 (POE) 是白内障手术后的一种严重并发症.
- 糖尿病是POE的潜在风险因素,但这种关联需要澄清.
研究的目的:
- 在接受白内障手术的糖尿病患者中系统地审查和元分析POE风险.
- 为了比较糖尿病和非糖尿病患者之间的POE发生率和相关风险因素.
主要方法:
- 按照PRISMA指南进行系统审查和元分析.
- 在主要数据库 (PubMed,Scopus,Medline,Embase,Google Scholar) 进行全面的文献搜索,截至2024年9月.
- 包括RCT和观察性研究,分析POE结果,并使用随机效应模型计算聚合几率比率 (OR).
主要成果:
- 包括九项研究;七项进行了元分析,显示糖尿病患者的POE发病率较高 (0.261%对0.242%).
- 糖尿病男性的POE风险高出1.634倍;糖尿病和高血压的联合风险增加了3.961倍.
- 后囊破裂 (PCR) 显著增加了POE风险 (OR:3.434),特别是在糖尿病患者中. 手术后的抗生素降低了POE风险 (OR:0.231).
结论:
- 糖尿病患者在白内障手术后面临POE和PCR显著增加的风险.
- 室内和局部抗生素有效地降低了糖尿病和非糖尿病患者的POE风险.
- 强调血糖/血压控制,手术精度以防止PCR,以及明智的抗生素使用以减轻POE风险.
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