手术前的血红蛋白A1c和最少的侵入性腰椎手术:它是否像我们想象的那样重要?
Yifei Sun1, Sasha Howell2, Lucia D Juarez3
1Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
Acta neurochirurgica
|November 8, 2025
概括
高的手术前血红蛋白A1c (HbA1c) 水平与经过轻微侵入性腰椎手术后的再入院和再手术增加有关. 在手术前优化HbA1c可能会改善患者的治疗结果.
科学领域:
- 脊柱外科手术 脊柱外科手术
- 代谢健康 代谢健康
- 患者的治疗结果.
背景情况:
- 最少侵入性的腰椎脊椎手术越来越常见.
- 手术前的血红蛋白A1c (HbA1c) 对手术结果至关重要.
- 对于HbA1c对最小侵入性腰部手术的影响尚不清楚.
研究的目的:
- 为了研究手术前HbA1c与腰椎脊椎微创手术后的结果之间的关联.
- 评估高HbA1c与再入院,再手术和并发症之间的关系.
主要方法:
- 对1013名接受了最小侵入性腰部手术的患者 (2011-2023) 的回顾性审查.
- 对手术前HbA1c水平和手术结果的分析.
- 使用多变量逻辑回归和倾向得分匹配.
主要成果:
- 高HbA1c (>7.1%) 的患者有更高的90天再入院 (OR 2.02) 和重新手术 (OR 2.82) 的几率.
- 高HbA1c与持续症状 (OR 2.9) 的重新手术增加有关.
- 倾向性得分匹配显示,高HbA1c患者的住院时间更长,尿路感染率更高.
结论:
- 术前升高的HbA1c水平与最小侵入性腰椎手术的不良结果相关.
- 建议进行手术前的HbA1c控制,以优化手术结果.
- 对HbA1c值和干预措施的进一步研究是有必要的.
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