■随着各国将其合法化,大麻的使用可能会增加,并成为社会可接受的。大麻使用史可能会增加各种手术后并发症的风险,并损害功能恢复。在这里,我们系统地回顾和荟萃分析了大麻使用史如何影响髋关节或膝关节置换术(THA/TKA)后恢复的现有证据。
■PubMed,EMBASE,和WebofScience数据库进行了全面搜索,并根据PRISMA指南选择和分析了研究。纳入研究的方法学质量根据纽卡斯尔-渥太华量表进行评估。而证据质量是根据“建议分级评估”进行评估的,发展,和评估系统。在适当的时候汇集各种结果的数据并进行荟萃分析。
■系统评价包括16项队列研究,涉及591万患者。荟萃分析将大麻使用史与以下结果的高风险联系起来:修订(RR1.68,95%CI1.31-2.16),机械松动(RR1.77,95%CI1.52-2.07),假体周围骨折(RR1.85,95%CI1.38-2.48),位错(RR2.10,95%CI1.18-3.73),心血管事件(RR2.49,95%CI1.22-5.08),脑血管事件(RR3.15,95%CI2.54-3.91),肺炎(RR3.97,95%CI3.49-4.51),呼吸衰竭(RR4.10,95%CI3.38-4.97),尿路感染(RR2.46,95%CI1.84-3.28),急性肾损伤(RR3.25,95%CI2.94-3.60),静脉血栓栓塞(RR1.48,95%CI1.34-1.63),深静脉血栓形成(RR1.42,95%CI1.19-1.70)。此外,使用大麻与术后输血风险显著增加(RR2.23,95%CI1.83-2.71)以及较高的住院费用相关。
■大麻使用史显著增加了THA或TKA后大量并发症和输血的风险,导致更高的医疗成本。临床医生在治疗大麻使用者时应考虑这些因素,术前方案应特别考虑有cannbis使用史的患者。
UNASSIGNED: Cannabis use may be increasing as countries legalize it and it becomes socially acceptable. A history of
cannabis use may increase risk of complications after various kinds of surgery and compromise functional recovery. Here we systematically reviewed and meta-analyzed available evidence on how history of
cannabis use affects recovery after hip or knee arthroplasty (THA/TKA).
UNASSIGNED: The PubMed, EMBASE, and Web of Science databases were comprehensively searched and studies were selected and analyzed in accordance with the PRISMA guidelines. The methodological quality of included studies was assessed based on the Newcastle-Ottawa Scale, while quality of evidence was evaluated according to the \"Grading of recommendations assessment, development, and evaluation\" system. Data on various outcomes were pooled when appropriate and meta-analyzed.
UNASSIGNED: The systematic review included 16 cohort studies involving 5.91 million patients. Meta-analysis linked history of
cannabis use to higher risk of the following outcomes: revision (RR 1.68, 95% CI 1.31-2.16), mechanical loosening (RR 1.77, 95% CI 1.52-2.07), periprosthetic fracture (RR 1.85, 95% CI 1.38-2.48), dislocation (RR 2.10, 95% CI 1.18-3.73), cardiovascular events (RR 2.49, 95% CI 1.22-5.08), cerebrovascular events (RR 3.15, 95% CI 2.54-3.91), pneumonia (RR 3.97, 95% CI 3.49-4.51), respiratory failure (RR 4.10, 95% CI 3.38-4.97), urinary tract infection (RR 2.46, 95% CI 1.84-3.28), acute kidney injury (RR 3.25, 95% CI 2.94-3.60), venous thromboembolism (RR 1.48, 95% CI 1.34-1.63), and deep vein thrombosis (RR 1.42, 95% CI 1.19-1.70). In addition,
cannabis use was associated with significantly greater risk of postoperative transfusion (RR 2.23, 95% CI 1.83-2.71) as well as higher hospitalization costs.
UNASSIGNED: History of cannabis use significantly increases the risk of numerous complications and transfusion after THA or TKA, leading to greater healthcare costs. Clinicians should consider these factors when treating cannabis users, and pre-surgical protocols should give special consideration to patients with history of cannbis use.