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慢性抗凝剂对膝关节整形术后早期术后结果的影响:一项TrinetX数据库研究

Andrea H Johnson¹, Jane C Brennan¹, Shawn S Simpson¹

¹Department of Orthopedics, Luminis Health Anne Arundel Medical Center, Annapolis, MD, USA.

Arthroplasty today

|May 9, 2025

概括

慢性抗凝药治疗的患者在麻醉下操纵,修复全膝关节整形术 (TKA) 和TKA后伤口并发症的风险更高. 需要进一步的研究来了解和减轻这些增加的风险.

科学领域:

整形外科手术整形外科手术
药理学药理学是指药理学的学科.
医疗并发症医疗并发症

背景情况:

药物治疗静脉血栓塞栓症预防与术后并发症 (如出血和感染) 有关.
在慢性抗凝血治疗患者的全膝关节整形术 (TKA) 并发症,特别是麻醉下的操纵 (MUA) 和TKA修订方面存在有限的研究.
现有的文献主要集中在预防上,而不是对TKA患者的长期抗凝管理.

研究的目的:

评估在经历过慢性抗凝血治疗的TKA患者在麻醉下操纵 (MUA) 的发生率.
在这个患者群体中评估其他早期术后并发症,包括修订TKA和伤口破坏.
为了比较TKA患者与没有慢性抗凝血病史之间的并发症率.

主要方法:

在TrinetX数据库中追溯查询与外科手术期间的tranexamic acid进行TKA的患者.
在手术后6个月内根据慢性抗凝剂使用情况将患者划分为队列.
倾向性得分对人口统计和并发症数据进行匹配,结果为每组7367名患者.

主要成果:

接受慢性抗凝药的患者患MUA的可能性是1.72倍 (OR:1.718,P <.001).
在一年内观察到TKA修订的概率高1.32倍 (OR: 1.324,P = .044) 和伤口破坏的概率高1.53倍 (OR: 1.530,P < .001).
在慢性抗凝治疗队列中,MUA,修订TKA和伤口并发症的显著增加被注意到.

结论:

患有慢性抗凝药的膝关节整形术患者在一年内经历了更糟糕的术后结果.
增加MUA,修订TKA和伤口并发症的风险与慢性抗凝药有关.
需要进一步调查以验证研究结果,并确定针对这一群体的风险减轻策略.

关键词:

关节纤维化是关节纤维化的一种疾病.慢性抗凝血药物慢性抗凝血剂在麻醉下进行操纵.术后并发症术后并发症主要全膝关节关节整形手术

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