在整部关节整形手术中使用手术前的双酸盐:无论治疗持续时间如何,都安全
Seok Ha Hong1, Yeon Ju Yu2, Seung Beom Han1
1Department of Orthopaedic Surgery, College of Medicine, Korea University, Seoul, South Korea.
The bone & joint journal
|November 30, 2025
概括
在关节整形手术 (THA) 之前,术前使用双酸盐 (BP) 不会增加诸如周围假肢骨折或修复等并发症的风险. 患者因素,而不是血压持续时间,是不利结果的关键.
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.
- 老年医学 老年医学
背景情况:
- 最近的研究表明,手术前使用双酸盐 (BP) 可能会增加关节整形术 (THA) 后的并发症.
- 这与BP在骨质疏松症管理中的已知好处形成鲜明对比.
- 在THA的背景下了解与BP使用相关的特定风险对于患者安全至关重要.
研究的目的:
- 为了确定术前BP使用是否与接受THA与外科手术期间BP治疗的患者的不良外科结果有关.
- 调查手术前BP使用的持续时间是否会影响THA后并发症的风险.
主要方法:
- 对全国范围的韩国索赔数据库对50岁以上的患者进行分析,这些患者接受了单边的THA与外科手术期间的BP.
- 患者被分为"前后"的BP使用",仅"后"的BP使用,或对照组.
- 使用倾向分数匹配 (PSM),然后按BP持续时间对"前后"组进行分层.
主要成果:
- 与对照组相比,在手术前使用BP并未被发现是周围假肢骨折 (PPF) 或THA后修复的风险因素.
- 手术后使用BP与修订风险降低有关 (HR 0.74).
- 更长的手术前血压持续时间 (超过三年) 显示PPF风险明显降低 (HR 0.39).
结论:
- 在THA使用前六个月或更长时间的术前双酸盐使用是安全的,不会增加PPF或修复的风险.
- 患者特异性因素,包括并发症和关节骨折史,是围围假肢并发症的更重要的风险因素,而不是BP使用.
- 手术前血压治疗的持续时间似乎不会增加并发症风险,并且可能提供保护性益处.
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