伤口对冲引流治疗颈椎后路单开门术后切口感染的效果分析  

Effect Analysis of Wound Drainage for the Treatment of Incision Infection after Operation of Cervical Posterior Single Door

作　　者：张楠[1] 田发明 刘子洪[1] 刘志奎[1] Zhang Nan Tian Fa-ming Liu Zi-hong et al.(Department of Orthopedics, Tangshan Kailuan General Hospital of Hebei Province, Tangshan 063000, Chin)

机构地区：[1]河北省唐山市开滦总医院骨科,唐山063000

出　　处：《中国医药导刊》2017年第4期367-367,369,共2页Chinese Journal of Medicinal Guide

基　　金：河北省青年科技课题(项目编号:20150832),课题名称:颈椎后路单开门术后切口感染的相关因素分析及治疗

摘　　要：目的:探讨颈后路单开门术后切口感染应用伤口对冲引流治疗方式的效果,为临床实践提供指导。方法:回顾性分析2000年1月~2011年12月我院颈椎专业组收治行颈椎后路单开门术式的全部感染病例共25例,7例行清创术后直接缝合,1例行清创后切除椎板每日手术室开放换药,后对冲引流,17例清创术后行对冲引流。对治疗方法及效果进行分析描述。结果:感染病例中1例体温增高伴WBC升高。累及至项韧带及更深层次23例。9例分泌物培养检验出病原菌。感染病例4例应用1种抗生素,3例应用2种抗生素,1例应用3种抗生素,1例应用4种抗生素,对无病原菌存在病例应用常规抗生素治疗。25例患者均得到治愈。结论:感染病例特点多为项韧带以深感染,多为无细菌生长的感染,存在病原菌病例表现为低毒力感染症状。治疗以彻底清创及应用广谱抗生素或敏感抗生素为必要条件,对冲引流为有效方法,内固定物取出不是治疗感染的必要条件。Objective： To analysis of the treatment result of hedge drainage for the open-door laminoplasty wound infection, provide guidance for the clinical practice. Metliods： A retrospective analysis from January 2000 to December 2011, cervical professional group were al infection 25 cases. In 7 cases after debridement and direct suture, 1 case after debridement and resection of vertebral lamin operation room daily,at last with the hedge drainage,1 cases underwent debridement hedge draand effects were analyzed to describe. Results ： 1 case with WBC and temperature increase. Drag to the nuchal ligament and deeper in 23 ca-ses. 9 cases exist pathogenic bacteriaof through bacterial culture test. 4 cases of application of 1 kinds of antibiotics ,3 cases of the applicationof 2 kinds of antibiotics, 1 case of the application of 3 kinds of antibiotics, 1 cases of application of 4 kinds of antibiotic, no case of conventional antibiotic therapy. All the 25 cases are cured. Conclusion ： Infection is characterized by a ligament to deep infection, as no growth of bacteria infection, presence of pathogens show low toxicity symptoms of infection cases. Treatment with a thorough debridement and application of broad-spectrum antibiotics or antibiotics as a necessary condition, hedge drainage is an efftreatment of infection is not necessary condition.

关 键 词：颈椎后路 单开门术后 感染 伤口对冲引流 治疗 

分 类 号：R687.3[医药卫生—骨科学]