腰椎间盘术后椎间隙感染9例临床分析  

Clinical analysis of 9 cases diagnosed with postoperative discitis of lumbar

作　　者：俞雷钧[1] 张春[1] 刘宏[1] 陆建伟[1] 颜瑞健[1] 江彬锋[1] 

机构地区：[1]浙江省立同德医院骨伤科,浙江杭州310012

出　　处：《中华医院感染学杂志》2013年第11期2614-2616,共3页Chinese Journal of Nosocomiology

摘　　要：目的探讨椎间盘术后腰椎间隙感染的发病原因、主要临床表现、症状特征及治疗效果,旨在为临床腰椎间盘术后椎间隙感染的早期诊断提供依据,评估病灶清除并局部抗菌药物冲洗引流方法的治疗效果。方法收集1999年9月-2011年9月入住骨科的9例腰椎间盘术后椎间隙感染患者的临床资料,研究选择的所有患者均采用病灶清除、局部抗菌药物冲洗引流的方法进行治疗,对其临床资料进行回顾性分析。结果患者随访时间为6个月～6年,平均随访时间为24个月,所有患者临床症状均消失,原病变部位腰椎活动基本恢复正常,未见感染复发,工作和劳动能力均恢复正常。结论病灶清除并局部抗菌药物灌洗治疗腰椎间盘术后椎间隙感染治疗效果良好,可用作腰椎间盘术后椎间隙感染的治疗的重要方法之一,在腰椎间盘术后椎间隙感染的治疗过程中,血沉恢复对其疗效的判断具有全程指导意义。OBJECTIVE To explore the causes, main clinical features, characteristics of symptoms, and effect of treatment of postoperative discitis of lumbar so as to afford the evidence for early clinical diagnosis of postoperative discitis of lumbar and estimate the therapeutic effect of surgical debridement to local lesions following continuous closed irrigation with antibiotics solution. METHODS The clinical data of 9 cases of patients who were diagnosed with postoperative discitis of lumbar in the orthopedics department from Sep 1999 to Sep 2011 were collected. All the patients were treated with surgical debridement to local lesions following continuous closed irrigation with antibiotics solution, and the clinical data were retrospectively analyzed. RESULTS After a 6-month to 6-year follow-up, with the mean follow-up of 24 months, the study concluded that all the clinical features disappeared, the lumbar motion of the primary lesion site restored, there were no cases of recurrent infections, and the working ability of all the patients restored to normal. CONCLUSION Continuous closed irdgation with antibiotic solution is a preferred choice for the patients with postoperative discitis of lumbar. The erythrocyte sedimentation recovery is a good marker throughout all the treatment.

关 键 词：腰椎间盘术后椎间隙感染 诊断 治疗 腰椎 

分 类 号：R687.3[医药卫生—骨科学]