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术前脱水对术后并发症的影响脚骨折开放式缩减内部固定

Alexander S Guareschi¹, William N Newton¹, Jared J Reid¹

¹Department of Orthopaedics and Physical Medicine, Medical University of South Carolina, Charleston, South Carolina.

Foot & ankle specialist

|March 17, 2025

概括

在接受脚骨折手术的患者中,手术前脱水与更高的并发症率有关. 然而,多变量分析表明,脱水状态不是短期不良结果的重要预测因素.

科学领域:

整形外科手术整形外科手术
手术结果研究研究.
患者的水分状态

背景情况:

手术前的流体状况是影响手术结果的关键因素.
了解脱水对接受脚骨折手术的患者的影响对于风险分层至关重要.

研究的目的:

为了研究手术前脱水和30天后术后并发症,再入院,再手术和脚骨折手术后死亡率之间的关联.
为了确定手术前脱水是否是一个独立的风险因素,在骨骨折的开放缩小和内部固定 (ORIF) 后的不良结果.

主要方法:

使用美国外科医生学院 (ACS) 国家外科质量改善计划 (NSQIP) 数据库进行回顾性队列研究.
包括27,175名因脚骨折接受ORIF治疗的患者.
根据血尿素与肌素比率>20的数据,将患者分为正常水合 (n=18,761) 和脱水 (n=8,414) 的两组.

主要成果:

脱水患者的心脏骤停,心肌梗塞,需要输血的出血,肺栓塞和尿路感染的发生率显著增加.
在水化组之间的30天再接收或重新运行率中没有发现显著差异.
多变量回归分析显示,水分状态不是任何不良结果,住院时间或总手术时间的重要预测因素.

结论:

虽然单变量分析显示脱水患者的并发症增加,但多变量分析不支持脱水作为短期术后并发症的独立预测因子.
术前脱水状态似乎不会显著增加短期术后并发症,再入院,再手术或关节骨折后死亡的风险 ORIF.

关键词:

脚骨折脚骨折在脚上脱水脱水脱水脱水流体状态流体状态开放式减速内部固定方式

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