腰椎间盘术后椎间隙感染后路手术的疗效分析  

Efficacy of lumbar intervertebral disc space infections after surgery

作　　者：陈汉文[1] 高书明[1] 李民[1] 李书奎[1] 

机构地区：[1]沧州市中心医院骨一科,河北沧州061001

出　　处：《中华医院感染学杂志》2015年第14期3289-3290,3293,共3页Chinese Journal of Nosocomiology

基　　金：河北省科技厅基金资助项目(12227986D);河北省沧州市科技局基金资助项目(09ZD247)

摘　　要：目的探讨患者腰椎后路清除病灶以及减压引流手术治疗腰椎间盘术后椎间隙感染的临床疗效。方法回顾性分析2002年5月-2013年5月腰椎间盘术后椎间隙感染患者42例,研究患者临床表现和实验室相关检查结果以及诊断要点,其中行保守治疗的19例为保守组,行后路手术治疗的23例患者为后路组,将治疗的相关结果进行记录总结,疗效分析指标以使用抗菌药物的天数、绝对卧床时间、临床症状减轻及住院时间和X线片的相关指标恢复时间等评价两种治疗方案的临床疗效。结果保守治疗的患者使用抗菌药物平均时间为47.6d,绝对卧床时间为122.7d,治疗后腰痛症状减轻较慢,15-18d后症状消失,平均住院时间为81.1d,且X线片显示椎间隙平均融合时间为257.9d;而经后路组内患者平均使用抗菌药物时间为15.4d,平均卧床时间为47.6d,住院时间平均为27.5d,X线片显示患者的椎间隙平均融合时间为164.5d,且手术后腰痛症状减缓速度较快,6-9d症状消失,两组比较差异均有统计学意义（P〈0.05）。结论经后路手术的临床疗效明显优于传统的保守治疗方案,值得临床推广应用。OBJECTIVE To investigate the clinical efficacy of posterior lumbar clearance of lesions and drainage decompression for treating intervertebral disc space infections after lumbar surgery.METHODS A retrospective analysis was conducted on 42 patients who had postoperative lumbar intervertebral disc infections during May 2002 to May 2013,the patient＇s clinical manifestations and laboratory results as well as key points of diagnosis were studied.The 19 patients who received conservative treatment were set as the conservative group,and the 23 patients who received posterior surgical treatment as the posterior group.The relevant results of the treatment were recorded and summarized.The clinical efficacy of two treatment regimens was evaluated by the efficacy measurements such as the number of days of antimicrobial use,the absolute time in bed,clinical symptom alleviation,hospital stays and related recovery indicators by X-rays,etc.RESULTS The average usage time of antimicrobial drugs,the absolute time in bed,the average hospital stay and the average fusion time of intervertebral space by X-rays were47.6days,122.7days,81.1days,and 257.9days for the conservative group and 15.4days,47.6days,27.5days,and 164.5days for the posterior group.The patient＇s clinical symptoms alleviated slowly and dissolved 15-18 days later in the conservative group,while the symptoms alleviated fast and dissolved 6-9days later in the posterior group.The differences were significant between the two groups（P〈0.05）.CONCLUSIONThe posterior surgical treatment was superior to the traditional conservative treatment in clinical efficacy,which is worthy of clinical application.

关 键 词：腰椎间盘术 后路手术 椎间隙感染 疗效分析 

分 类 号：R619.3[医药卫生—外科学]