抗感染治疗对脊柱骨折伴硬脊膜损伤术后脑脊液漏治疗结局及颅内感染影响  

Influence of anti-infection therapy on treatment outcomes of postoperative cerebrospinal fluid leakage and intracranial infection in spinal fracture patients complicated with dural injury

作　　者：吴永铁[1] 孙厚杰[1] 张晗祥[1] 范华华[1] 杨波[1] 

机构地区：[1]贵州省遵义市第一人民医院骨科二病区,贵州遵义563000

出　　处：《中华医院感染学杂志》2016年第21期4928-4930,共3页Chinese Journal of Nosocomiology

基　　金：贵州省卫生厅科学技术基金项目(2015J-002)

摘　　要：目的研究抗感染治疗对脊柱骨折伴硬脊膜损伤术后脑脊液漏治疗结局及颅内感染的影响,为临床治疗提供依据。方法选取2014年6月-2016年2月于医院进行治疗的56例脊柱骨折伴硬脊膜损伤患者为研究对象,将其随机分为对照组28例和观察组28例,对照组进行常规治疗,观察组则在对照组基础上以抗菌药物进行治疗,然后将两组患者的脑脊液漏消失时间、切口愈合时间、颅内感染率、治疗前及治疗后不同时间的感染相关血清指标进行比较。结果观察组的脑脊液漏消失时间<3d者及切口愈合时间<2周者比例分别为78.57%及71.43%,均高于对照组的39.29%及35.71%,观察组的颅内感染总发生率为3.57%,明显低于对照组的14.28%,治疗后不同时间的感染相关血清指标水平也均低于对照组,差异均有统计学意义(P<0.05)。结论抗感染治疗对脊柱骨折伴硬脊膜损伤术后脑脊液漏治疗结局及颅内感染的影响更为积极,因此认为本治疗在患者中的应用价值较高。OBJECTIVE To explore the influence of anti-infection therapy on treatment outcomes of postoperative cerebrospinal fluid leakage and intracranial infection in spinal fracture patients complicated with dural injury so as to provide guidance for clinical treatment. METHODS A total of 56 spinal fracture patients complicated with dural injury who were treated in the hospital from Jun 2014 to Feb 2016 were recruited as the study objects and random- ly divided into the control group with 28 cases and the observation group with 28 cases. The control group was giv- en the conventional therapy, the observation group was treated with antibiotics on the basis of the therapy of the control group. The time of disappearance of cerebrospinal fluid leakage, incision healing time, incidence of in- tracranial infections, and the infection-related serological indicators were observed and compared between the two groups of patients. RESULTS The proportion of the patients with the time of disappearance of cerebrospinal fluid leakage less than 3 days of the observation group was 78.57%, higher than 39. 29% of the control group;the propontion of the patients with mcrsion neaing time less than 2 weeks of the observation group was 71.43%, higher than 35.71% of the control group. The total incidence of intracranial infections of the observation group was 3.57 %, significantly lower than 14. 28 % of the control group. The levels of the infection-related serological indica- tors of the observation group were lower than those of the control group after the treatment, and there was signifi- cant difference （P〈0.05）. CONCLUSION The anti-infection therapy shows more positive effect on the treatment outcomes and intracranial infections in the. spinal fracture patients complicated with dural injury. It is concluded that the therapy had higher application value.

关 键 词：抗感染治疗 脊柱骨折 硬脊膜损伤 术后脑脊液漏 治疗结局 颅内感染 

分 类 号：R683.2[医药卫生—骨科学]