严重肥胖患者膝关节整形术后的血栓栓塞风险:使用日本医疗声明数据的大规模分析
Yu Mori1, Kunio Tarasawa2, Hidetatsu Tanaka1
1Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-Ku, Sendai, Miyagi 980-8574, Japan.
概括
在日本患者中,严重肥胖会增加静脉血栓塞栓症 (VTE) 的风险. 同时进行双侧手术也会增加静脉突发症的风险, 需要对肥胖患者进行仔细的外科护理.
科学领域:
- 骨科手术
- 血管外科
- 肥胖药物
背景情况:
- 肥胖是膝关节整形术后并发症的一个已知的危险因素.
- 严重肥胖 (BMI ≥35 kg/ m2) 对接受膝关节整形手术的日本患者术后结果的具体影响仍未得到充分研究.
研究的目的:
- 在日本人群中调查严重肥胖和全膝关节整形术 (TKA) 和单隔膝关节整形术 (UKA) 后的术后并发症之间的关联.
- 在该患者队列中确定静脉血栓塞栓症 (VTE) 的危险因素.
主要方法:
- 使用日本诊断程序组合 (DPC) 数据库进行的回顾性队列研究 (2016年4月至2023年3月).
- 包括接受TKA或UKA的患者,分为严重肥胖 (BMI ≥35 kg/ m2) 和非严重肥胖 (BMI < 35 kg/ m2) 的组.
- 通过基平方测试和逻辑回归,对手术后并发症进行比较分析.
主要成果:
- 对7832个匹配对的分析显示,严重肥胖组的深静脉血栓 (OR 1.16) 和肺栓塞 (OR 1.79) 发生率显著增加.
- 同时进行双侧手术被确定为静脉瘤的独立危险因素.
- 在手术部位感染,住院时间或输血量方面没有发现显著差异.
结论:
- 在日本患者进行膝关节整形手术后,严重肥胖是静脉突发症的独立危险因素.
- 同时进行双侧手术也是该群体中静脉瘤的重要危险因素.
- 这些发现强调了为接受膝关节整形手术的严重肥胖患者量身定制的术后治疗策略的重要性.
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