术前结肠镜是初级整部关节整形术后重新手术的危险因素:基于人口的研究
Talal Al-Jabri1, Matthew J Wood2, Lauren L Nowak3
1Trauma and Orthopaedic Surgery, Guy's and St Thomas' NHS Foundation Trust, Great Maze Pond, London, United Kingdom; Trauma and Orthopaedic Surgery, Department of Surgery and Cancer, Imperial College London, London, United Kingdom.
The Journal of arthroplasty
|March 30, 2025
概括
接受全关节整形手术 (THA) 并且最近进行结肠镜检查的患者面临重新手术的更高风险. 当结肠镜检查更接近THA手术时,这种风险会显著升级.
科学领域:
- 整形外科手术 整形外科手术
- 胃肠病学 胃肠病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 对于经过手术前结肠镜检查的患者的关节整形术 (THA) 后的重新手术风险,研究有限.
- THA和结肠镜都是类似患者人口统计学常见的程序,突出显示了理解它们的综合影响的差距.
研究的目的:
- 调查手术前结肠镜和初级THA后重新手术的风险之间的关联.
- 为了确定结肠镜相对于THA的时间是否会影响重新手术率.
主要方法:
- 一项使用加拿大安大略省 (2003-2020年) 的行政数据进行的回顾性队列研究.
- 鉴定了接受骨关节炎初级THA治疗的患者,并将进行手术前结肠镜检查 (≤1年前) 和对照组 (1:10比) 匹配,使用倾向性得分匹配.
- 分析了THA后五年内使用考克斯比例危险模型的重新运行率.
主要成果:
- 1515名手术前结肠镜检查的患者与15150名对照人群进行了匹配.
- 在五年内,结肠镜组的重新手术率为4.0%,对照组为2.8%.
- 在12个月内进行手术前结肠镜检查时,重新手术的风险增加了1.39倍,如果在THA后83天内进行,风险增加到1.91倍.
结论:
- 在THA前长达12个月的诊断性结肠镜检查可能会增加术后重新手术的风险.
- 存在时间关系,当结肠镜检查更接近THA日期时,观察到更高的重新操作风险.
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