腰椎间隙感染采用经皮穿刺腰椎间盘切除联合闭式冲洗引流治疗的临床疗效  

The clinical efficacy of percutaneous lumbar discectomy combined closed irrigation and drainage for lumbar space infection

作　　者：王淅克 黄岩石 郑铁牛 吴迪 罗恒超 吴潇 WANG Xi-ke;HUANG Yan-shi;ZHENG Tie-niu;WU Di;LUO HENG-chao;WU Xiao(Nanyang Second People＇s Hospital of Henan Province,Nanyang,Henan 473012,China)

机构地区：[1]南阳市第二人民医院疼痛科,河南南阳473012

出　　处：《中华医院感染学杂志》2018年第16期2518-2521,共4页Chinese Journal of Nosocomiology

摘　　要：目的探讨腰椎间隙感染采用经皮穿刺腰椎间盘切除联合闭式冲洗引流治疗的临床疗效。方法选择2010年1月-2015年12月于医院诊断治疗的41例腰椎间隙感染患者的临床资料进行回归性分析,将其中采用经皮穿刺腰椎间盘切除术联合闭式冲洗引流治疗的22例患者作为手术组,采用保守治疗的19例患者作为保守组。分别于治疗前、治疗后1天、治疗后1周、出院前以及出院后3个月采用视觉模拟评分方法(VAS)评价患者疼痛程度;术后3个月采用Oswestry伤残评分(ODI)量表以及日本骨科学会评分(JOA)评价患者恢复情况。比较两组患者疼痛消失时间、C-反应蛋白(CRP)恢复正常时间、红细胞沉降率(ESR)恢复正常时间以及住院天数;出院后3个月评价两组患者临床疗效。结果治疗后1天、治疗后1周,手术组患者VAS评分分别为(3.9±1.0)分、(3.2±0.7)分,均低于保守组患者(7.6±1.1)分、(4.5±1.3)分(P<0.05);治疗后3个月,两组患者ODI评分分别为(3.3±1.0)分、(3.1±0.9)分,JOA评分分别为(26.4±3.0)分、(25.9±3.3)分,与治疗前比较,两组患者ODI评分均下降、JOA评分升高(P<0.05);手术组患者疼痛消失时间(13.3±2.5)d、CRP恢复正常时间(20.0±2.1)d、ESR恢复正常时间(31.3±1.5)d以及住院时间(33.1±2.7)d均短于对照组患者(P<0.05)。结论腰椎间隙感染采用经皮穿刺腰椎间盘切除联合闭式冲洗引流治疗能够快速缓解疼痛,快速控制感染,缩短患者住院时间。OBJECTIVE To discuss the clinical efficacy of percutaneous lumbar discectomy combined closed irrigation and drainage for lumbar space infection.METHODS The clinical data of 41 cases with lumbar space infection diagnosed in our hospital from Jan.2010 to Dec.2012 were retrospectively analyzed.22 cases treated with percutaneous lumbar discectomy combined closed irrigation and drainage were set as the operation group,and 19 cases treated with conservative treatment were set as the conservative group.The pain levels were evaluated by VAS before treatment,1 day after treatment,1 week after treatment,before discharge and 3 months after discharge.Patient recovery was evaluated by ODI and JOA 3 months after discharge.The time of pain disappearance,the period of normal recovery of CRO,the period of normal recovery of ESR and the length of hospital stay were compared between the two groups.The clinical efficacy of the two groups was compared 3 months after discharge.RESULTS The VAS scores of the operation group（3.9±1.0,3.2±0.7）were significantly lower than those of the conservative group（7.6±1.1,4.5±1.3）at the time of one day after treatment and one week after treatment significantly（P〈0.05）.The ODI scores of both groups（3.3±1.0,3.1±0.9）3 months after discharge were lower than those before treatment,and the JOA scores of both groups（26.4±3.0,25.9±3.3）were significantly higher than those before treatment（P〈0.05）.The time of pain disappearance（13.3±2.5 d）,the period of normal recovery of CRP（20.0±2.1 d）,the period of normal recovery of ESR（31.3±1.5 d）and the length of hospital stay（33.1±2.7 d）of the operation group were all significantly shorter than those of the conservative group（P〈0.05）.CONCLUSIONPercutaneous lumbar discectomy combined closed irrigation and drainage for treatment of lumbar space infection can quickly relieve pain,rapidly control of infection,and shorten patient＇s hospitalization time.

关 键 词：腰椎间隙感染 经皮穿刺腰椎间盘切除 闭式冲洗引流 临床疗效 

分 类 号：R681.5[医药卫生—骨科学]