[1]周毅强,何匀曦,陈凯,等.类风湿关节炎合并骨折患者的围手术期处理[J].中华老年骨科与康复电子杂志,2019,(05):301-305.[doi:10.3877/cma.j.issn.2096-0263.2019.05.011]
 Zhou Yiqiang,He Yunxi,Chen Kai,et al.Perioperative management of the patients with rheumatoid arthritis undergoing fracture[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2019,(05):301-305.[doi:10.3877/cma.j.issn.2096-0263.2019.05.011]
点击复制

类风湿关节炎合并骨折患者的围手术期处理()
分享到:

中华老年骨科与康复电子杂志[ISSN:1674-3911/CN:11-9292/R]

卷:
期数:
2019年05期
页码:
301-305
栏目:
综述
出版日期:
2019-10-05

文章信息/Info

Title:
Perioperative management of the patients with rheumatoid arthritis undergoing fracture
作者:
周毅强1何匀曦2陈凯1吴雅冰3邱明山4张建新1
361009 厦门市中医院骨科1,医务科3,风湿科4;361102 厦门大学附属翔安医院康复科2
Author(s):
Zhou Yiqiang1 He Yunxi2 Chen Kai1 Wu Yabing3 Qiu Mingshan4 Zhang Jianxin1
1Department of Orthopedics, 3Department of Medical, 4Department of Rheumatism, Xiamen 361009, China; 2Department of Rehabilitation, Xiangan Hospital Affiliated to Xiamen University , Xiamen 361102, China.
关键词:
类风湿关节炎 骨折 围手术期
Keywords:
Arthritis rheumatoid Fractures bone Perioperative period
DOI:
10.3877/cma.j.issn.2096-0263.2019.05.011
文献标志码:
A
摘要:
类风湿关节炎好发于中老年人,其病情复杂、合并症多,一旦发生骨折则围手术期处理难度大且风险较高。本文就类风湿关节炎患者骨折围手术期评估、围手术期用药管理及骨折的预防进行综述,以期减少此类患者围手术期风险,保障医疗安全。
Abstract:
Rheumatoid arthritis (RA) tends to occur in middle-aged and elderly people. Rheumatoid arthritis is complicated, which is usually associated with many complications. The perioperative management of the patients with rheumatoid arthritis and fracture is difficult and with high risk. In this paper, the perioperative assessment, the perioperative drug administration and the prevention of fracture were reviewed in order to reduce the perioperative risk and ensure medical safety.

参考文献/References:

1 Goodman SM, Figgie MA. Arthroplasty in patients with established rheumatoid arthritis (RA): Mitigating risks and optimizing outcomes [J]. Best Pract Res Clin Rheumatol, 2015, 29(4/5): 628-642.
2 Zhai L, Song Z, Liu K. The effect of gabapentin on acute postoperative pain in patients undergoing total knee arthroplasty a Meta-Analysis [J]. Medicine, 2016, 95(20): e3673.
3 Goodman SM, Springer B, Guyatt G, et al. 2017 American college of rheumatology/American association of hip and knee surgeons guideline for the perioperative management of antirheumatic medication in patients with rheumatic diseases undergoing elective total hip or total knee arthroplasty [J]. J Arthroplasty, 2017, 32(9): 2628-2638.
4 Megan, L, Krause, et al. Perioperative management of the patient with rheumatoid arthritis [J]. World J Orthop, 2014, 5(3): 283-291.
5 赵良春, 肖涟波. 类风湿关节炎关节置换围手术期处理 [J]. 国际骨科学杂志, 2014, 35(3): 161-163.
6 Kristensen SD, Knuuti J, Saraste A, et al. 2014 ESC/ESA guidelines on non-cardiac surgery:cardiovascular assessment and management [J]. Kardiol Pol, 2014, 72(11): 857-918.
7 Zhang J, Chen L, Delzell E, et al. The association between inflammatory markers, serum lipids and the risk of cardiovascular events in patients with rheumatoid arthritis [J]. Ann Rheum Dis, 2014, 73(7): 1301-1308.
8 李春, 王秀茹, 唐熠达, 等. 全国多中心类风湿关节炎冠心病危险因素的现况调查 [J]. 北京大学学报:医学版, 2012, 44(2): 176-181.
9 高展望, 甄平. 类风湿性关节炎关节置换:围置换期的主要风险管理 [J]. 中国组织工程研究, 2015, 19(53): 8664-8669.
10 Koch MC, Pereira IA, Souza Nobre LF, et al. Computed tomography of pulmonary changes in rheumatoid arthritis: carcinoembryonic antigen (CEA) as a marker of airway disease [J]. Rheumatol Int, 2016, 36(4): 531-539.
11 Sargin G, Senturk T. Multiple pulmonary rheumatoid nodules [J]. Reumatologia, 2015, 53(5): 276-278.
12 Mori S, Koga Y, Sugimoto M. Different risk factors between interstitial lung disease and airway disease in rheumatoid arthritis [J]. Respir Med, 2012, 106(11): 1591-1599.
13 何善智, 丁菱, 王敏, 等. 类风湿关节炎合并肺部类风湿结节的危险因素分析 [J]. 实用医学杂志, 2017, 33(10): 1665-1668.
14 Mahmoud I, Tekaya AB, Tekaya R, et al. Pulmonary nodules in a patient with rheumatoid arthritis:Which diagnostic approach is the most appropriate? [J]. Caspian J Intern Med, 2017, 8(3): 220-222.
15 Wang JX, Du CG. A retrospective study of clinical characteristics of interstitial lung disease associated with rheumatoid arthritis in Chinese patients [J]. Med Sci Monit, 2015, 21: 708-715.
16 宋良月, 左大辰, 张榕, 等. 类风湿关节炎合并肺间质疾病患者临床特点 [J]. 中华临床免疫和变态反应杂志, 2015 (2): 85-90.
17 Kelly CA, Saravanan V, Nisar MA, et al. Rheumatoid arthritis-related interstitial lung disease: associations, prognostic factors and physiological and radiological characteristics-a large multicentre UK study [J]. Rheumatology, 2014, 53(9): 1676-1682.
18 Joaquim AF, Ghizoni E, Tedeschi H, et al. Radiological evaluation of cervical spine involvement in rheumatoid arthritis [J]. Neurosurg Focus, 2015, 38(4): E4.
19 刘大猛, 周新社. 类风湿关节炎患者全膝置换术术前评估 [J]. 中国骨与关节杂志, 2016 (2): 153-157.
20 20 Aires RB, De Carualho JF, Henrique Da Mota LM. Pre-operative anesthetic assessment of patients with rheumatoid arthritis [J]. Rev Bras Reumatol, 2014, 54(3): 213-219.
21 史占军, 吕厚山, 许建中, 等. 类风湿关节炎的诊断与治疗骨科专家共识 [J]. 中国医学前沿杂志:电子版, 2013, 5(3): 49-52.
22 高华利, 肖涟波, 翟伟韬, 等. 多模式镇痛与静脉自控镇痛对类风湿关节炎全膝关节置换术围手术期镇痛效果的病例对照研究 [J]. 中国骨伤, 2017, 30(4): 356-359.
23 Palabiyik O, Tuna AT, Bayar F, et al. Combined Sciatic-Femoral Nerve Block in Patient with Coexisting Ankylosing Spondylitis and Rheumatoid Arthritis[J]. Firat Med J, 2014, 19(4): 214-216.
24 刘凤林, 张太平. 中国普通外科围手术期血栓预防与管理指南 [J]. 消化肿瘤杂志:电子版, 2016, 54(2): 57-62.
25 Granziera S, Cohen AT. VTE primary prevention, including hospitalised medical and orthopaedic surgical patients [J]. Thromb Haemost, 2015, 113(6): 1216-1223.
26 Galanis T, Merli GJ. Venous Thromboembolism Prophylaxis in the Patient with Rheumatic Diseases Undergoing Orthopedic Surgery[M]// Perioperative Management of Patients with Rheumatic Disease. Springer New York, 2013:45-56.
27 Chung WS, Peng CL, Lin CL, et al. Rheumatoid arthritis increases the risk of deep vein thrombosis and pulmonary thromboembolism: a nationwide cohort study [J]. Ann Rheum Dis, 2014, 73(10): 1774-1780.
28 Kim SC, Schneeweiss S, Liu J, et al. Risk of venous thromboembolism in patients with rheumatoid arthritis [J]. Arthritis Care Res (Hoboken), 2013, 65(10): 1600-1607.
29 Antonella, Mameli, Francesco, et al. Thromboembolic disease in patients with rheumatoid arthritis undergoing joint arthroplasty: Update on prophylaxes [J]. World J Orthop, 2014, 5(5): 645-652.
30 Lee JJ, Pope JE. A meta-analysis of the risk of venous thromboembolism in inflammatory rheumatic diseases [J]. Arthritis Res Ther, 2014, 16(5): 435-444.
31 中国健康促进基金会血栓与血管专项基金专家委员会, 中华医学会呼吸病学分会肺栓塞与肺血管病学组, 中国医师协会呼吸医师分会肺栓塞与肺血管病工作委员会. 医院内静脉血栓栓塞症防治与管理建议 [J]. 中华医学杂志, 2018, 98(18): 1383-1388.
32 Caprini JA. Risk assessment as a guide for the prevention of the many faces of venous thromboembolism [J]. Am J Surg, 2010, 199(1 Suppl): S3-10.
33 周云杉, 穆荣. 类风湿关节炎患者接受择期骨科手术围手术期的药物治疗 [J/CD]. 中华关节外科杂志:电子版, 2011, 5(1): 75-79.
34 Chechik O, Thein R, Fichman G, et al. The effect of clopidogrel and aspirin on blood loss in hip fracture surgery [J]. Injury, 2011, 42(11): 1277-1282.
35 Zhang CG, Wang GD, Liu XY, et al. Safety of continuing aspirin therapy during spinal surgery A systematic review and meta-analysis [J]. Medicine, 2017, 96(46): e8603.
36 Meier R, Marthy R, Saely CH, et al. Comparison of preoperative continuation and discontinuation of aspirin in patients undergoing total hip or knee arthroplasty [J]. Eur J Orthop Surg Traumatol, 2016, 26(8): 921-928.
37 Santolini E, West R, Giannoudis PV. Risk factors for long bone fracture non-union: a stratification approach based on the level of the existing scientific evidence [J]. Injury, 2015, 46(8): S8-S19.
38 徐建国, 唐会, 姚尚龙, 等. 肾上腺糖皮质激素围手术期应用专家共识(2017版) [J]. 临床麻醉学杂志, 2017, 33(7): 712-716.
39 Goodman SM. Optimizing perioperative outcomes for older patients with rheumatoid arthritis undergoing arthroplasty: emphasis on medication management [J]. Drugs Aging, 2015, 32(5): 361-369.
40 中华医学会骨科学分会. 中国骨科大手术静脉血栓栓塞症预防指南 [J]. 中华骨科杂志, 2009, 29(6): 602-604.
41 Bang SM, Jang MJ, Kim KH, et al. Prevention of venous thromboembolism, 2nd edition: Korean Society of Thrombosis and Hemos
tasis Evidence-based Clinical Practice Guidelines [J]. J Korean Med Sci, 2014, 29(2): 164-171.
42 Kearon C, Akl EA, Ornelas J, et al. Antithrombotic therapy for VTE disease: CHEST guideline and expert panel report [J]. Chest, 2016, 149(2): 315-352.
43 岳辰, 周宗科, 裴福兴, 等. 中国髋、膝关节置换术围术期抗纤溶药序贯抗凝血药应用方案的专家共识 [J]. 中华骨与关节外科杂志, 2015, 8(4): 281-285.
44 Mohib Y, Rashid RH, Ali M, et al. Does tranexamic acid reduce blood transfusion following surgery for inter-trochanteric fracture? A randomized control trial [J]. J Pak Med Assoc, 2015, 65(11 Suppl 3): S17-S20.
45 Gausden EB, Garner MR, Warner SJ, et al. Tranexamic acid in hip fracture patients: a protocol for a randomised, placebo controlled trial on the efficacy of tranexamic acid in reducing blood loss in hip fracture patients [J]. BMJ Open, 2016, 6(6): e010676.
46 Farrow LS, Smith TO, Ashcroft GP, et al. A systematic review of tranexamic acid in hip fracture surgery [J]. Br J Clin Pharmacol, 2016, 82(6): 1458-1470.
47 Tengberg PT, Foss NB, Palm H, et al. Tranexamic acid reduces blood loss in patients with extracapsular fractures of the hip RESULTS OF A RANDOMISED CONTROLLED TRIAL [J]. Bone Joint J, 2016, 98B(6): 747-753.
48 Suzuki Y, Wakabayashi T. Management of osteoporosis associated with rheumatoid arthritis and glucocorticoid-induced osteoporosis [J]. Clin Calcium, 2015, 25(12): 1825-1834.
49 Ma CC, Xu SQ, Gong X, et al. Prevalence and risk factors associated with glucocorticoid-induced osteoporosis in Chinese patients with rheumatoid arthritis [J]. Arch Osteoporos, 2017, 12(1): 33.
50 Liu JJ, Shan LC, Deng BY, et al. Reason and treatment of failure of proximal femoral nail antirotation internal fixation for femoral intertrochanteric fractures of senile patients [J]. Genet Mol Res, 2014, 13(3): 5949-5956.
51 Mueller JU, Baldauf J, Marx S, et al. Cement leakage in pedicle screw augmentation: a prospective analysis of 98 patients and 474 augmented pedicle screws [J]. J Neurosurg Spine, 2016, 25(1): 103-109.
52 Hoes JN, Bultink IE, Lems WF. Management of osteoporosis in rheumatoid arthritis patients [J]. Expert Opin Pharmacother, 2015, 16(4): 559-571.
53 Feng ZY, Zeng SM, Wang YE, et al. Bisphosphonates for the prevention and treatment of osteoporosis in patients with rheumatic diseases: a systematic review and Meta-Analysis [J]. PLoS One, 2013, 8(12): e80890.
54 Panday K, Gona A, Humphrey MB. Medication-induced osteoporosis:screening and treatment strategies [J]. Ther Adv Musculoskelet Dis, 2014, 6(5): 185-202.
55 Park JH, Park EK, Koo DW, et al. Compliance and persistence with oral bisphosphonates for the treatment of osteoporosis in female patients with rheumatoid arthritis [J]. BMC Musculoskelet Disord, 2017, 18(1): 152-160.
56 Ebina K, Hirao M, Hashimoto J, et al. Assessment of the effects of switching oral bisphosphonates to denosumab or daily teriparatide in patients with rheumatoid arthritis [J]. J Bone Miner Metab, 2018, 36(4): 478-487.
57 El-Wakd M, Omar O, Ha SN. Prevalence of silent nontraumatic vertebral fracture in rheumatoid arthritis: relation with disease duration, disease activity, corticosteroid, and hip buckling ratio [J]. Egy Rheumatol Rehabil, 2014, 41(3): 116-121.
58 Dirven L, Van Den Broek M, Van Groenendael J, et al. Prevalence of vertebral fractures in a disease activity steered cohort of patients with early active rheumatoid arthritis [J]. BMC Musculoskelet Disord, 2012, 13(1): 125.
59 刘文, 徐胜前, 肖会, 等. 维生素D缺乏和跌倒在类风湿关节炎合并脊柱骨质疏松性骨折中的临床研究 [J]. 中华风湿病学杂志, 2015, 19(11): 740-744.

相似文献/References:

[1]马晓龙,刘强,吴斗,等.骨质疏松显微骨折早期发生发展过程的实验研究[J].中华老年骨科与康复电子杂志,2016,(03):129.[doi:10.3877/cma.j.issn.2096-0263.2016.03.001]
 Ma Xiaolong,Liu Qiang,Wu Dou,et al.Experimental study of osteoporotic microsurgery fractures in the early development process[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2016,(05):129.[doi:10.3877/cma.j.issn.2096-0263.2016.03.001]
[2]宋会平,张柳.阿仑膦酸钠治疗老年女性严重骨质疏松症患者的疗效分析[J].中华老年骨科与康复电子杂志,2016,(03):141.[doi:10.3877/cma.j.issn.2096-0263.2016.03.003]
 Song Huiping,Zhang Liu.Effcacy analysis of alendronate in the treatment of severe osteoporosis in senile women[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2016,(05):141.[doi:10.3877/cma.j.issn.2096-0263.2016.03.003]
[3]于沂阳,刘勃,陈伟,等.2008—2012 年河北医科大学第三医院老年骨折流行病学特征分析[J].中华老年骨科与康复电子杂志,2016,(03):172.[doi:10.3877/cma.j.issn.2096-0263.2016.03.009]
 Yu Yiyang,Liu Bo,Chen Wei,et al.Epidemiological analysis of geratic fractures in the Third Affiliated Hospital to Hebei Medical University from 2008 to 2012[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2016,(05):172.[doi:10.3877/cma.j.issn.2096-0263.2016.03.009]
[4]冯博,郝定均,郭浩.经皮椎体后凸成形术治疗老年骨质疏松性椎体压缩骨折的研究进展[J].中华老年骨科与康复电子杂志,2016,(03):185.[doi:10.3877/cma.j.issn.2096-0263.2016.03.012]
 Feng Bo,Hao Dingjun,Guo Hao.Research progress of percutaneous kyphoplasty treatment on senile osteoporotic vertebral compression fractures[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2016,(05):185.[doi:10.3877/cma.j.issn.2096-0263.2016.03.012]
[5]李坛珠,张保焜,莫小联,等.极高龄不稳定股骨粗隆间骨折的髓内和髓外固定疗效比较[J].中华老年骨科与康复电子杂志,2017,(01):17.[doi:10.3877/cma.j.issn.2096-0263.2017.01.004]
 Li Tanzhu,Zhang Baokun,Mo Xiaolian,et al.The comparative analysis of extramedullary to intramedullary fixations for unstable femur intertrochanteric fractures in elderly patients[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2017,(05):17.[doi:10.3877/cma.j.issn.2096-0263.2017.01.004]
[6]王峰,雷涛,苗德超,等.经皮椎体成形术与经皮椎体后凸成形术治疗重度骨质疏松性椎体压缩骨折的疗效对比[J].中华老年骨科与康复电子杂志,2017,(03):143.[doi:10.3877/cma.j.issn.2096-0263.2017.03.003]
 Wang Feng,Lei Tao,Miao Dechao,et al.Comparative analysis of percutaneous vertebroplasty and percutaneous kyphoplastyon for the elderly severe osteoporotic vertebral compression fractures[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2017,(05):143.[doi:10.3877/cma.j.issn.2096-0263.2017.03.003]
[7]雷涛,申勇.老年骨质疏松性椎体骨折若干问题的探讨[J].中华老年骨科与康复电子杂志,2017,(04):248.[doi:10.3877/cma.j.issn.2096-0263.2017.04.010]
 Lei Tao,Shen Yong..A brief discussion of osteoporotic vertebral fractures in elderly patients[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2017,(05):248.[doi:10.3877/cma.j.issn.2096-0263.2017.04.010]
[8]史冬立,贺宇,毕丛丛,等.疼痛管理在老年骨折快速康复护理中的应用现状[J].中华老年骨科与康复电子杂志,2017,(05):314.[doi:10.3877/cma.j.issn.2096-0263.2017.05.013]
 Shi Dongli,He Yu,Bi Congcong,et al.Research status of pain management of fast-track care in elderly patients with fractures[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2017,(05):314.[doi:10.3877/cma.j.issn.2096-0263.2017.05.013]
[9]马树伟.球囊扩张椎体成形术治疗急性与亚急性期骨质疏松椎体压缩骨折的疗效对比[J].中华老年骨科与康复电子杂志,2017,(06):341.[doi:10.3877/cma.j.issn.2096-0263.2017.06.005]
 Ma Shuwei.Clinical efficacy of percutaneous kyphoplasty in the treatment of acute and subacute phase of osteoporotic vertebral compression fractures[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2017,(05):341.[doi:10.3877/cma.j.issn.2096-0263.2017.06.005]
[10]刘曦明,陈龙,汪国栋,等.3D导航下微创空心螺钉内固定治疗中老年Tilt骨盆骨折的疗效观察[J].中华老年骨科与康复电子杂志,2018,(03):151.[doi:10.3877/cma.j.issn.2096-0263.2018.03.006]
 Liu Ximing,Chen Long,Wang Guodong,et al.The clinical efficacy of 3D image-guided minimally invasive screw fixation in the treatment of Tilt pelvic fracture in middle-aged and elderly patients[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2018,(05):151.[doi:10.3877/cma.j.issn.2096-0263.2018.03.006]

更新日期/Last Update: 2019-10-23