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[糖尿病与全关节置换术——应考虑哪些因素?]

[Diabetes mellitus and total joint arthroplasty-What should be considered?].

作者信息

Müller Michael, Weber Patrick

机构信息

Klinik für Orthopädie und Unfallchirurgie, Zentralklinik Bad Berka, Robert-Koch-Allee 9, 99438, Bad Berka, Deutschland.

ECOM - Praxis für Orthopädie, Sportmedizin und Unfallchirurgie, München, Deutschland.

出版信息

Orthopadie (Heidelb). 2025 Feb;54(2):129-134. doi: 10.1007/s00132-024-04598-0. Epub 2025 Jan 7.

Abstract

Diabetes mellitus (DM) is on the rise in the population. Approximately 10% of adults suffer from DM. Over two-thirds of patients are over 60 years old, and thus it particularly affects patients who have to undergo total joint arthroplasty. Patients with DM have an increased risk of surgical site infection and periprosthetic infections. The risk particularly affects patients with inadequately controlled DM. Diabetes control can be monitored using HbA, which correlates with both the adjustment and the risk of infection. HbA should therefore be determined in all patients with DM before a prosthesis is implanted. Patients with HbA over 8% should be seen by a diabetologist and have their blood sugar control optimized.

摘要

糖尿病(DM)在人群中的发病率呈上升趋势。约10%的成年人患有糖尿病。超过三分之二的患者年龄在60岁以上,因此它尤其影响那些必须接受全关节置换术的患者。糖尿病患者手术部位感染和假体周围感染的风险增加。这种风险尤其影响糖尿病控制不佳的患者。可以使用糖化血红蛋白(HbA)来监测糖尿病的控制情况,它与感染的调整及风险均相关。因此,在植入假体之前,所有糖尿病患者都应测定HbA。HbA超过8%的患者应由糖尿病专科医生诊治,并优化其血糖控制。

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