营养状态对关节置换围手术期的影响

Effect of nutritional status on total joint arthroplasty

关节置换围手术期营养状态长期被低估,为了总结现有的关节置换围手术期营养状态、并发症以及治疗现状,检索PubMed、MEDLINE、Cochrane、EMBASE、CINAHL数据库中现有的关节置换围手术期营养状态相关研究,评价分析关节置换术围手术期营养状态以及相关并发症。结果表明初次TJA患者的术前营养不良比例为15%～30%,翻修患者营养不良比例更高,大多超过50%。营养不良患者关节置换术后总并发症比例显著升高,包括切口愈合不良、手术部位感染以及假体周围感染等,增加严重并发症发生率、住院时间及二次入院率。围手术期应当重视关节置换患者营养状态,从而减少关节置换术后并发症发生率。应进一步探索关节置换围手术期营养治疗的随机临床研究。

The perioperative nutritional status in total joint arthroplasty(TJA) has been underestimated for long time. To summarize the current studies of perioperative nutritional status, complications, and relative treatment in TJA, the databases, including PubMed, MEDLINE, Cochrane, EMBASE and CINAHL are searched for relative studies. The perioperative nutritional status and related complications of TJA are evaluated. This review reveals that the rate of preoperative malnutrition in patients undergoing primary TJA is 15 %~30%, and over 50% in those of revision TJA. The incidence of complications is significantly higher in patients with malnutrition, including poor wound healing, surgical site infection, and prosthetic joint infection. In addition malnutrition increases the incidence of serious complications, lengthens hospital stay, and adds readmission. Attention should be paid to the nutritional status of TJA patients during perioperative period to reduce the incidence of complications. Further investigation should be conducted to investigate the perioperative nutritional treatment of TJA with randomized clinical trials.