颈后路单开门椎板成形术后伤口深部感染的处理  

Management of deep wound infection after cervical posterior single open-door laminoplasty

作　　者：王飞[1] 马玉泉[1] 强华[1] 顾树明[1] 王国栋[1] 

机构地区：[1]首都医科大学附属北京同仁医院骨科,100730

出　　处：《北京医学》2009年第11期660-662,共3页Beijing Medical Journal

摘　　要：目的探讨颈后路单开门椎板成形术后伤口深部感染及并发化脓性脑脊膜炎的治疗方法。方法分析112例颈后路单开门椎管成形术中,术后发生伤口深部感染4例患者的资料,其中2例因脑脊液漏并发化脓性脑脊膜炎。结果4例患者均彻底清创后一期关闭伤口、置管持续冲洗,2例同时行腰穿蛛网膜下腔置管引流。4例均治愈且神经功能恢复满意。结论颈后路单开门椎板成形术后伤口深部感染是一种严重的并发症,尤其并发脑脊液漏引起化脓性脑脊膜炎,如处理不当会危及生命,一旦发生应引起高度重视。伤口清创持续冲洗,合理的抗生素应用及蛛网膜下腔置管引流等是基本的治疗措施。Objective To analyse treatment of deep wound infection and cerebrospinal meningitis complicated after cervical posterior single open-door laminoplasty. Methods 112 patients received cervical posterior single open-door laminoplasty in our hospital between February 1998 and June 2008. Four of them suffered from deep wound infection after operation and 2 cases of wound infection had cerebrospinal fluid leakage （CSFL） which leaded to cere- brospinal meningitis. Results Four cases were treated with debridement, first stage close incisions and continuous irrigation. Two cases with cerebrospinal meningitis cured by continuous drainage through subarachnoid cavity. Conclusions Deep wound infection ,especially cerebrospinal meningitis after cervical posterior singIe open-door laminoplasty, is a serious postoperative complication and should be treated carefully.Reasonable antibiotics,irrigation and continuous drainage through subarachnoid cavity are effective methods.

关 键 词：深部感染 颈椎 手术后并发症 

分 类 号：R687.3[医药卫生—骨科学]