术前皮质类固醇注射和时间与手腕道释放后的术后深层感染无关
Annika N Hiredesai1, Alejandro M Holle, Ammon Driggs
1From the Mayo Clinic Alix School of Medicine, Scottsdale, AZ (Hiredesai, Holle, and Driggs), the Department of Orthopedic Surgery, Mayo Clinic (Lin, Verhey, and Lai), and the Division of Hand Surgery, Department of Orthopedic Surgery, Mayo Clinic, Phoenix, AZ (Noland).
概括
在手腕道释放 (CTR) 之前进行手术前的皮质类固醇注射 (CSI) 不会增加深度术后感染的风险. 这项研究发现,在90天内,无论注射时间如何,都没有发现高感染率.
科学领域:
- 整形外科手术 整形外科手术
- 手术手术手术手术手术
- 传染病流行病学 传染病流行病学
背景情况:
- 现有文献表明,在手腕道释放 (CTR) 之前注射皮质类固醇 (CSI) 后,术后感染的风险可能会增加.
- 这种潜在风险的确切时机尚不清楚.
- 这项研究调查了手术前CSI时间和术后深层感染 (PDI) 率之间的关联.
研究的目的:
- 为了确定CTR前90天内CSI是否与较高的PDI率有关.
- 评估CSI的时间 (0-30,31-60,或CTR前61-90天) 是否影响PDI风险.
主要方法:
- 一个大型的行政索赔数据库 (PearlDiver M170) 用于识别接受CTR.的患者.
- 在CTR前90天内接受ipsilateral CSI的患者与没有接受CSI的对照进行了匹配.
- 针对PDI率分析了匹配的队列,CSI时间进一步分为0-30,31-60和61-90天的间隔.
主要成果:
- 对每个队列中的17,125名匹配患者的分析显示,与对照组相比,接受手术前CSI的患者的PDI风险没有显著增加.
- 根据CSI时间 (0-30,31-60,61-90天) 的分层分析也显示,与对照相比,PDI风险没有显著增加.
结论:
- 在手腕道释放之前进行手术前的皮质类固醇注射,在任何研究的时间点都没有与术后深层感染的风险增加有关.
- 这些发现与一些现有文献形成鲜明对比,并可能为手腕道综合征的非手术和手术治疗选择做出手术决策.
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