术后结肠镜会增加关节周围假肢感染的风险吗? 一个系统的审查和元分析
L R Benaroch1, V Roy1, R Alatassi1
1University of Western Ontario, London Heath and Sciences Centre, University Hospital.
The Journal of arthroplasty
|August 22, 2025
概括
在全关节整形术 (TJA) 后,结肠镜检查不会增加周围关节感染 (PJI) 的风险. 识别和管理患者的风险因素是减少PJI率和改善结果的关键.
科学领域:
- 骨科手术
- 传染性疾病
- 胃肠病学
背景情况:
- 周围假肢关节感染 (PJI) 是全关节整形术 (TJA) 后的一个重大并发症.
- 从偏远地区的血液传播是PJI的常见原因,需要对某些手术进行抗生素预防.
- 在TJA患者的结肠镜检查后存在PJI风险的相互矛盾证据.
研究的目的:
- 在经过TJA的患者进行结肠镜检查后系统地审查和元分析PJI的风险.
- 为TJA患者提供基于证据的结肠镜安全性指导.
主要方法:
- 在EMBASE,MEDLINE,CINAHL和CENTRAL数据库中进行系统搜索.
- 包括5个队列研究,共505079名患者.
- 使用随机效应模型和通用逆方差方法的元分析.
主要成果:
- 结肠镜检查后3个月,6个月,9个月或1年没有明显增加PJI风险.
- 统计数据显示,结肠镜检查与PJI之间没有显著的关联.
- 患PJI的独立危险因素包括糖尿病,类风湿性关节炎,慢性病,酒,吸烟,肺部疾病,男性性和创伤后关节炎.
结论:
- 术后结肠镜没有显著增加TJA患者的PJI风险.
- 虽然整体上该程序似乎是安全的,但识别和修改个别风险因素对于缓解PJI至关重要.
- 积极管理风险因素可以改善接受结肠镜检查的TJA患者的治疗结果.
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