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减重手术与腕管综合征的关联:一项倾向评分匹配队列研究。

The association of bariatric surgery and carpal tunnel syndrome: A propensity score-matched cohort study.

机构信息

Barts Bone and Joint Health, Blizard Institute, Queen Mary University of London, London, UK; Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, UK.

Upper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden.

出版信息

J Plast Reconstr Aesthet Surg. 2024 Oct;97:245-255. doi: 10.1016/j.bjps.2024.07.015. Epub 2024 Jul 15.

Abstract

OBJECTIVES

To test the hypothesis that weight loss following bariatric surgery is associated with a reduced risk of developing carpal tunnel syndrome (CTS) compared with obese patients who do not undergo bariatric surgery.

METHODS

We performed a cohort study using data from the Swedish nationwide healthcare registries. Patients aged 18-79 years who underwent bariatric surgery from 2006 to 2019 were propensity score (PS)-matched to up to 2 obese bariatric surgery-free patients ("unexposed patients"). Cox proportional hazard regression was used to calculate hazard ratios (HR) with 95% confidence intervals (CIs) to compare the incidence of CTS among bariatric surgery patients to obese unexposed patients both overall and divided by subgroups of age, sex, bariatric surgery type, and duration of follow-up.

RESULTS

In total, 40,619 bariatric surgery patients were PS-matched to 63,540 obese unexposed patients who did not undergo surgery. Bariatric surgery was not associated overall with CTS (HR 0.98, 95% CI 0.91-1.05). There was a 23% decreased risk of CTS incidence observed within >1-3 years after bariatric surgery (HR 0.77, 95% CI 0.68-0.88). Decreased CTS risks were observed among bariatric surgery patients aged 18-34 years (HR 0.87, 95% CI 0.74-1.01) and those who underwent sleeve gastrectomy (HR 0.81, 95% CI 0.63-1.03), but these risks did not reach significance level compared with obese unexposed patients. However, there was a 20% increased CTS risk after 6 years (HR 1.20, 95% CI 1.05-1.36).

CONCLUSION

Our results suggest that marked weight does not have a lasting impact on the reduction of CTS incidence.

摘要

目的

验证以下假设,即与未接受减重手术的肥胖患者相比,减重手术后体重减轻与发生腕管综合征(CTS)的风险降低相关。

方法

我们使用来自瑞典全国医疗保健登记处的数据进行了队列研究。2006 年至 2019 年间接受减重手术的年龄在 18-79 岁的患者,根据倾向评分(PS)与多达 2 名未接受过减重手术的肥胖患者(“未暴露患者”)进行匹配。使用 Cox 比例风险回归计算风险比(HR)及其 95%置信区间(CI),以比较减重手术患者与肥胖未暴露患者的 CTS 发生率,总体和按年龄、性别、减重手术类型和随访时间的亚组进行比较。

结果

共有 40619 名减重手术患者与 63540 名未接受手术的肥胖未暴露患者进行了 PS 匹配。总体而言,减重手术与 CTS 无关(HR 0.98,95%CI 0.91-1.05)。在减重手术后>1-3 年内,观察到 CTS 发病率降低了 23%(HR 0.77,95%CI 0.68-0.88)。在年龄在 18-34 岁的减重手术患者(HR 0.87,95%CI 0.74-1.01)和接受袖状胃切除术的患者(HR 0.81,95%CI 0.63-1.03)中,CTS 风险降低,但与肥胖未暴露患者相比,这些风险未达到统计学意义水平。然而,在 6 年后,CTS 风险增加了 20%(HR 1.20,95%CI 1.05-1.36)。

结论

我们的结果表明,显著的体重减轻对 CTS 发病率的降低没有持久影响。

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