一期前路病灶清除联合自体骨植骨钛板内固定治疗脊柱化脓性感染  

Investigation on the clinical effect and prognosis of titanium plate fixation in pyogenic spinal infection patients

作　　者：俞伟杨[1] 何登伟[1] 朱科军[1] 刘飞俊[1] 吴忠伟[1] 朱烨[1] 

机构地区：[1]浙江省温州医科大学附属第五医院(丽水市中心医院)骨科,323000

出　　处：《中华全科医学》2015年第4期529-531,共3页Chinese Journal of General Practice

基　　金：浙江省公益技术应用研究项目(2011C33026);浙江省医药卫生科技计划项目(2014KYB315)

摘　　要：目的 脊柱化脓性感染在骨外科不常见,所以对该病的诊治方面的认识还远远不够。本研究旨在通过对照研究进一步探讨一期前路病灶清除联合植骨钛板内固定治疗脊柱化脓性感染的临床疗效及预后,从而为指导临床脊柱化脓性感染的规范化治疗提供临床依据。方法 选择丽水市中心医院2008年5月—2013年5月收治的19例脊柱化脓性感染患者作为研究对象。所有患者采用一期前路病灶清除联合自体骨植骨钛板内固定术治疗,比较患者手术前后血白细胞水平（WBC）、C反应蛋白（CRP）、红细胞沉降率（ESR）水平和后凸角、胸背疼痛程度;对患者进行为期1年的随访,分析患者的预后情况。所有数据结果 通过方差分析或秩和检验方法 进行统计学分析。结果 所有患者手术均顺利完成,手术时间45-170 min,平均（105.4±37.5）min。植骨融合时间2-9个月,平均（4.7±2.5）个月;术后3个月,患者血WBC、ESR和CRP水平均较术前相比有显著降低（P〈0.05）;术后患者后凸角显著减小,胸背疼痛程度明显减轻,与治疗期相比差异具有统计学意义（P〈0.05）。19例患者细菌培养结果 呈阳性,其中最常见的是大肠埃希菌（36.84%）和金黄色葡萄球菌（26.31%）。结论 一期前路病灶清除联合自体植骨联合钛板内固定术是治疗脊柱化脓性感染有效的方法 ,能显著地改善患者的预后,值得临床借鉴。Objective Pyogenic spinal infection was not common, so the understanding of the diagnosis and treatment of this disease was still far from enough. The aim of this study was to explore the clinical effect and prognosis of titanium plate fixation in pyogenic spinal infection patients. Methods To select 19 cases of pyogenic spinal infection patients as the object of study and all patients were treated by internal fixation with titanium plate, compared blood WBC, ESR, CRP levels and kyphosis, Kyphosis and chest pain before and after operation, for a period of I years of follow-up of the patients, prognosis of patients was analyzed. All the data were statistically analyzed by ANOVA or rank sum test method. Results Operations were successfully completed in all patients, operation time was 45 - 170 min, average （ 105.4 ± 37.5 ） min. The fusion of time from 2 to 9 months, averaged （4.7 ±2.5 ） months ;3 months after surgery, patients＇ serum WBC, ESR and CRP were significantly lower（P 〈 0. 05 ） ; postoperative kyphosis decreased significantly, chest and back pain was significantly reduced （ P 〈 0.05 ）. In 19 patients, the results of bacterial culture were positive, of which the most common were the Escherichia coli（36.84% ） and Staphylococcus aureus （26.31% ）. Conclusion Antologous bone graft combined titanium plate fixation was an effective method for treatment of pyogenic spinal infection patients, it was worthy of clinical reference.

关 键 词：钛板内固定术 脊柱化脓性感染 自体植骨术 预后 

分 类 号：R681.51[医药卫生—骨科学] R687.32[医药卫生—外科学]