腰椎术后椎间隙感染切口病灶清除术治疗效果分析  

Effect of primary incision debridement on treatment of intervertebral space infections after lumbar spine surgery

作　　者：胡家美[1] 乐敏莉[2] 徐新华[1] 唐尚权[1] 熊国相[1] 

机构地区：[1]湖北民族学院附属民大医院脊柱外科,湖北恩施445000 [2]湖北民族学院附属民大医院放射科,湖北恩施445000

出　　处：《中华医院感染学杂志》2015年第2期407-408,411,共3页Chinese Journal of Nosocomiology

基　　金：湖北省卫生厅科研基金资助项目(JX4B54)

摘　　要：目的探究对腰椎术后椎间隙感染患者进行切口病灶清除手术的治疗效果,为临床治疗腰椎术后间隙感染提供一定借鉴。方法对比分析与回顾性分析相结合,调查2006年3月-2013年3月收治的28例腰椎术后间隙感染患者治疗资料,根据其采用的治疗方法进行分组,12例患者采用抗菌药物输液及卧床休息保守治疗方法为A组;16例患者采用切口病灶清除手术治疗为B组,对A、B两组的治疗方法进行分析,并对治疗过程中的相关数据进行比较。结果 A组患者的平均疼痛消失、体温恢复时间分别为13、10周,多于B组患者的7、4周,差异有统计学意义(P<0.05);A组患者的平均红细胞沉降率正常时间、C-反应蛋白转阴时间分别为11、9.5周,多于B组患者的6.5、4周,差异有统计学意义(P<0.05);A组患者平均住院时间2.3个月,长于B组患者的1.1个月,差异有统计学意义(P<0.05);A组患者的住院花费分别为2.77万元,略少于B组患者的3.44万元。结论切口病灶切除手术疗效好、病程短,能够彻底清除病变部位的炎性组织、抑制细菌生长,减少患者由于长期卧床而引起的并发症,临床可推广该方法进行腰椎术后椎间隙感染的治疗。OBJECTIVE To explore the effect of primary incision debridement on treatment of intervertebral space infections in patients undergoing lumbar spine surgery so as to provide guidance for clinical treatment of the postoperative intervertebral space infections.METHODS By means of comparative analysis combined with retrospectively analysis,the clinical data of 28 patients who underwent the lumbar spine surgery from Mar 2006 to Mar2013and were complicated with postoperative space infections were investigated,the patients were grouped according to the treatment measures the group A with 12 patients was treated with injection of antibiotics and conservative bed rest,and the group B with 16 cases was given the primary incision debridement;the treatment measures that were adopted in the two groups were analyzed,and the related data were observed and compared during the treatment.RESULTS The mean time of disappearance of pain of the group A was 13 weeks,longer than 7weeks of the group B;the mean time of recovery of body temperature of the group A was 10 weeks,longer than 4weeks of the group B,there was significant difference（P〈0.05）.The mean time of normal erythrocyte sedimentation rate of the group A was 11 weeks,longer than 6.5weeks of the group B;the mean time of negative C-reactive protein of the group A was 9.5weeks,longer than 4weeks of the group B,there was significant difference（P〈0.05）.The average length of hospital stay of the group A was 2.3months,longer than 1.1months of the group B,with statistical significance（P〈0.05）.The hospitalization cost of the group A was 0.277 million yuan,slightly less than 0.344 million yuan of the group B.CONCLUSIONThe primary incision debridement can achieve good effect,completely eradicate the inflammatory tissues around the lesion sites inhibit the bacterial growth,and reduce the incidence of complications induced by the long bedridden,with the disease course short,it is worthy to be promoted for the treatment of intervertebral space infections after the lumbar

关 键 词：腰椎手术 椎间隙感染 切口病灶清除 

分 类 号：R619.3[医药卫生—外科学]