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目的：探讨老年糖尿病患者接受全膝关节置换术(TKA)的临床疗效。方法：选择2022年1月—2024年1月于宜昌市中心人民医院行单侧TKA的65岁以上患者120例，根据是否合并糖尿病分为合并糖尿病的观察组(n=56)和不合并糖尿病的对照组(n=64)。比较两组患者的基线资料、手术相关指标、围手术期并发症及术后膝关节功能评分。结果：观察组患者高血压(85.71%vs 37.50%)和心功能异常(69.64%vs 42.19%)的发生率显著高于对照组；与对照组相比，观察组患者术前住院日[(6.23±3.12)天vs (3.61±3.43)天]和总住院日[(20.83±7.52)天vs (17.81±6.92)天]显著延长，术中出血量[(285.13±75.23) mL vs (245.12±68.13)mL]明显升高；两组患者的围手术期并发症中，观察组患者伤口延迟愈合发生率显著高于对照组(19.64%vs 4.69%);观察组患者术后6个月SF-36生理功能评分显著低于对照组[(75.32±12.63)分vs (81.52±11.82)分]。结论：老年糖尿病患者接受TKA安全可行，但存在更高的伤口延迟愈合风险，术前应积极控制血糖，优化围手术期管理，以改善患者预后。
Abstract：Objective: To explore the clinical efficacy of total knee arthroplasty(TKA) in elderly patients with diabetes. Methods: A total of 120 patients aged 65 and above who underwent unilateral total knee arthroplasty at Yichang Central People's Hospital from January 2022 to January 2024 were enrolled. All of the patients were divide into the observation group with diabetes(n=56) and the control group without diabetes(n=64) based on whether they had diabetes. The baseline data, surgery-related indexes, perioperative complications and postoperative functional scores of the two groups were compared. Results: The incidence of hypertension(85.71% vs 37.50%) and cardiac function abnormalities(69.64% vs 42.19%) in the observation group was significantly higher than those in the control group. Compared to the control group, the preoperative hospital stay [(6.23±3.12) days vs(3.61±3.43) days] and total hospital stay [(20.83±7.52) days vs(17.81±6.92) days] in the observation group were significantly longer, and the intraoperative blood loss [(285.13±75.23) mL vs(245.12±68.13) mL] was significantly higher. Among the perioperative complications of the two groups, the incidence of delayed wound healing in the observation group was significantly higher than in the control group(19.64% vs 4.69%). The SF-36 physical function score of the observation group at 6 months postoperatively was significantly lower than the control group [(75.32±12.63) vs(81.52±11.82)]. Conclusion: TKA in elderly diabetic patients is safe and feasible, while there exists a higher risk of delayed wound healing. Preoperative blood sugar should be actively controlled and perioperative management optimized to improve patient outcomes.
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基本信息:
中图分类号:R687.4;R587.1
引用信息:
[1]吴飞,刘健,郭辉福,等.老年糖尿病患者行全膝关节置换术的临床疗效分析[J].巴楚医学,2024,7(04):95-100.
基金信息:
湖北省自然科学基金项目(No:2021CFB488); 湖北省卫健委西医类重点项目(No:WJ2015MA025)
2024-12-30
2024-12-30