下肢骨折固定后的结局上与阿片类药物相关的外科手术期间疾病:来自多中心国家数据库的比较分析
Daniel E Pereira1, Zina Smadi2, Siddhant Bhat3
1Washington University, 1 Barnes Dr, St. Louis, MO, 63130, USA.
Injury
|December 10, 2025
概括
与阿片类药物相关的疾病增加了接受下肢骨折手术的患者的风险. 这些情况与更多的血栓,出血,感染以及较差的愈合结果 (如非联合和截肢) 有关.
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.
- 公共卫生 公共卫生
背景情况:
- 在需要为下肢骨折进行手术固定的患者中,阿片类药物的使用很普遍.
- 与阿片类药物相关的疾病 (OD) 存在风险,可能会损害骨愈合并导致内分泌病变.
- 调查外科手术期间的OD对开放性减少和内部固定 (ORIF) 后的结果的影响至关重要.
研究的目的:
- 评估术前与阿片类药物相关疾病 (OD) 对接受ORIF治疗下肢骨折的患者的短期和长期影响.
- 为了比较手术固定后具有和没有OD的患者之间的结果.
主要方法:
- 使用TrinetX数据库 (2003-2023) 的回顾性队列研究,随访时间≥2年.
- 确定了患有下肢骨折ORIF的患者,分为OD和对照队伍.
- 倾向性得分匹配 (1:1) 根据人口统计,BMI和并发症创建了可比的队列 (每一个n=3970).
主要成果:
- 在90天内,OD队列显示肺栓塞,深静脉血栓,输血,伤口并发症和贫血的比率更高.
- 在2年后,OD队列的非联合,修复/修复,与植入物相关的感染和截肢率增加.
- 显著的风险比率 (RR) 和p值表明与OD相关的并发症率较高.
结论:
- 外科手术期间与阿片类药物相关的疾病与血栓栓塞事件的增加,术后出血以及非结合,伤口问题,截肢和修订等并发症有关.
- 需要进一步的研究来阐明病理生理和心理社会机制,将OD与骨折和伤口愈合受损联系起来.
- 这些发现强调了在骨科创伤患者中管理OD的重要性.
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