胸腰椎内固定术后局部感染的临床治疗  

Management of postoperative infection in instrumented thoracolumbar spine

作　　者：林旭[1] 谭伦[1] 吴超[1] 丁勇[1] 曾俊[1] 郭勇[1] 王荣诗[1] 

机构地区：[1]自贡市第四人民医院骨科,四川643000

出　　处：《中国骨与关节损伤杂志》2015年第5期464-466,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的 探讨胸腰椎内固定术后局部感染的临床诊断和治疗策略。方法 回顾性分析自2008-03—2012-12诊治的胸腰椎内固定术后局部感染13例的临床资料。结果 13例胸腰椎内固定手术术后发生早期和晚期感染,感染发生时间术后1~13个月。经过及时诊断和积极的病灶清除、冲洗引流、抗感染治疗。除1例外,12例在保留内固定的情况下感染治愈。随访时间8~40（22±11）个月,无复发病例。感染后,清创引流术前、术后6个月血液分析、ESR、CRP和腰痛VAS评分,差异有统计学意义（P〈0.05）。结论 胸腰椎内固定术后局部感染后应及时明确诊断,尽早手术治疗。多数患者可以在保留内固定的情况下治愈感染。Objective To investigate the clinical diagnosis and treatment strategy of infection in instrumented thoracolumbar spine. Methods Thirteen surgical site infcction（SSI） cases of instrumented thoracolumbar spine between Mar. 2008 and Dee. 2012 were evaluated retrospectively. Results Thirteen patients had infections in the surgical site 1-13 months after operation. After timely diagnosis, aggressive debridement and irrigation, sensitive antibiotic therapy, infection was cured and implant was retained in 12 patients. All cases were followed up for 8 to 40 （22＋11）months, there were no cases of recurrence. Hemanalysis, the ESR, CRP and VAS score before and 6 months after debridement were analyzed, there were statistically significant differences （P 〈0.05）. Conclusion Postoperative infection after thoracolumbar internal fixation should be timely diagnosed and surgically treated. Through aggressive debridement, irrigation and sensitive antibiotic therapy, most patients, infections can be cured with instrument retained.

关 键 词：胸腰椎 感染 内置物 外科手术 

分 类 号：R687.3[医药卫生—骨科学]