中外医学研究
中外醫學研究
중외의학연구
CHINESE AND FOREIGN MEDICAL RESEARCH
2015年
22期
9-11
,共3页
关节置换术%强化血糖控制%手术切口感染%假体周围感染
關節置換術%彊化血糖控製%手術切口感染%假體週圍感染
관절치환술%강화혈당공제%수술절구감염%가체주위감염
Total joint arthroplasty%Intensive glucose control%Surgical site infection%Periprosthetic joint infection
目的：探究关节置换术围手术期最佳血糖控制水平和强化血糖控制对术后切口相关并发症的影响。方法：回顾2010-2014年行择期初次全髋关节置换术或全膝关节置换术的患者，根据术前血糖控制水平分为普通血糖控制组(空腹血糖水平7.8~10.0 mmol/L)与强化血糖控制组(空腹血糖水平4.4~7.8 mmol/L)，随访观察伤口渗液、切口部位感染、假体周围感染、低血糖、高血糖及心脑血管事件发生情况。结果：230例患者初次关节置换术患者纳入研究，其中糖尿病患者165例(71.7%)；强化血糖控制组2例(1.7%)患者发生手术部位感染率，普通血糖控制组8例(7.3%)，差异有统计学意义(P=0.021)，假体周围感染发生率无明显差异；强化血糖控制组有较少的伤口渗液发生率(7.5% vs 16.4%，P=0.037)；强化血糖控制还可减少平均住院日(P=0.018)；强化血糖控制组低血糖发生率较高(3.3% vs 1.8%)，差异无统计学意义(P=0.471)。结论：初次关节置换术围手术期强化血糖控制可有效降低术后早期切口并发症的发生率，但仍需改进方法避免低血糖的发生。
目的：探究關節置換術圍手術期最佳血糖控製水平和彊化血糖控製對術後切口相關併髮癥的影響。方法：迴顧2010-2014年行擇期初次全髖關節置換術或全膝關節置換術的患者，根據術前血糖控製水平分為普通血糖控製組(空腹血糖水平7.8~10.0 mmol/L)與彊化血糖控製組(空腹血糖水平4.4~7.8 mmol/L)，隨訪觀察傷口滲液、切口部位感染、假體週圍感染、低血糖、高血糖及心腦血管事件髮生情況。結果：230例患者初次關節置換術患者納入研究，其中糖尿病患者165例(71.7%)；彊化血糖控製組2例(1.7%)患者髮生手術部位感染率，普通血糖控製組8例(7.3%)，差異有統計學意義(P=0.021)，假體週圍感染髮生率無明顯差異；彊化血糖控製組有較少的傷口滲液髮生率(7.5% vs 16.4%，P=0.037)；彊化血糖控製還可減少平均住院日(P=0.018)；彊化血糖控製組低血糖髮生率較高(3.3% vs 1.8%)，差異無統計學意義(P=0.471)。結論：初次關節置換術圍手術期彊化血糖控製可有效降低術後早期切口併髮癥的髮生率，但仍需改進方法避免低血糖的髮生。
목적：탐구관절치환술위수술기최가혈당공제수평화강화혈당공제대술후절구상관병발증적영향。방법：회고2010-2014년행택기초차전관관절치환술혹전슬관절치환술적환자，근거술전혈당공제수평분위보통혈당공제조(공복혈당수평7.8~10.0 mmol/L)여강화혈당공제조(공복혈당수평4.4~7.8 mmol/L)，수방관찰상구삼액、절구부위감염、가체주위감염、저혈당、고혈당급심뇌혈관사건발생정황。결과：230례환자초차관절치환술환자납입연구，기중당뇨병환자165례(71.7%)；강화혈당공제조2례(1.7%)환자발생수술부위감염솔，보통혈당공제조8례(7.3%)，차이유통계학의의(P=0.021)，가체주위감염발생솔무명현차이；강화혈당공제조유교소적상구삼액발생솔(7.5% vs 16.4%，P=0.037)；강화혈당공제환가감소평균주원일(P=0.018)；강화혈당공제조저혈당발생솔교고(3.3% vs 1.8%)，차이무통계학의의(P=0.471)。결론：초차관절치환술위수술기강화혈당공제가유효강저술후조기절구병발증적발생솔，단잉수개진방법피면저혈당적발생。
Objective:To investigate the best perioperative glucose level in total joint arthroplasty and the effect of intensive glucose control on postoperative wound complications.Method:A retrospective study was conducted in patients undergoing primary total hip/knee arthroplsty from 2010 to 2014.They were assigned to either intensive glucose control with a blood glucose range of 4.4-7.8 mmol/L,or intermediate glucose control with a blood glucose range of 7.8-10.0 mmol/L.We defined primary end point as the incidence of surgical site infection or periprosthetic joint infection.Result:The number of patients undergoing total joint arthrolasty was 230 cases,165 cases(71.7%) were diabetes mellitus.Perioperatve intensive glucose control produced a significant reduction for the incidence of surgical site infection(1.7% vs 7.3%,P=0.021) and wound leakage(7.5% vs 16.4%,P=0.037).A shorter hospital stay was seen in intensive glucose control group(P=0.018).But intensive glucose control leaded a higher incidence of hypoglycemia(P=0.471).Conclusion:Intensive glucose control could reduce the incidence of postoperative wound complications in total joint arthroplasty,but attention should be paid to the incidence of hypoglycemia.
