颈椎化脓性感染的诊断与治疗(附6例随访观察)  

Diagnosis and treatment of the pyogenic infections of cervical spine

作　　者：张庆明[1] 沈惠良[1] 刘钊[1] 王居勇[1] 

机构地区：[1]首都医科大学宣武医院骨科,北京100053

出　　处：《中国骨与关节杂志》2013年第2期100-102,107,共4页Chinese Journal of Bone and Joint

摘　　要：目的通过回顾性分析颈椎化脓性感染患者的临床特点和治疗转归,探讨早期诊断和正确治疗的方法。方法 6例患者得到随访,其中男5例,女1例。年龄49～75岁。4例手术治疗,2例行保守治疗。随访时间15～58个月。随访末采用Frankel分级和Epstein评分。结果 4例手术治疗的患者,其中3例术后临床获得功能完全恢复或部分恢复,四肢肌力IV～V级。大小便功能完全恢复。1例存留有部分神经功能障碍,四肢肌力Ⅲ～IV^+级。非手术治疗2例,临床上获得完全恢复。无感染复发病例和死亡病例。结论颈椎化脓性感染早期可通过保守治疗得到治愈。手术指征包括神经损害进行性加重,椎体稳定性遭到破坏,椎体周围脓肿形成等。早期诊断和正确治疗非常重要。Objective To analyze clinical characteristics and results and to discuss the methods of early diagnosis and the proper treatment of patients with pyogenic infections of cervical spine. Methods 6 patients （5 male patients and 1 female patients） were followed up, with age ranged from 49 years old to 75 years. 2 patients accepted conservative treatment and 4 patients accepted surgeries. The duration of the follow up was from 15 months to 58 months. Frankel grading and Epstein score were applied to assess the results. Results 4 patients accepted surgeries. 3 patients among them regained partial or total function. The strength of the muscle was at V level. Feces and urinary function were totally recovered. 1 patient remained residual nerval disfunction, with strength of extremities’ muscles at the level from III to IV. 2 patients, accepting conservative treatment, recovered completely. No infection recured and no death. Conclusions Pyogenic infections of cervical spine can be treated earlier by conservative treatment. The indications of the surgery include progressive impair of the nerve function, damaged stabilization of the vertebra and abscess formation around the spine. It is of great importance to carry out diagnose and treatment at an earlier stage.

关 键 词：颈椎 化脓性感染 治疗 

分 类 号：R681.55[医药卫生—骨科学]