一期前路病灶清除、取髂骨植骨内固定治疗颈椎间隙化脓性感染的临床疗效  

Clinical effect of one-stage focus clearance,interbody fusion with ilium and internal fixation via the anterior approach for the treatment of pyogenic infection of cervical intervertebral space

作　　者：付能高[1] 张志明[1] FU Nenggao;ZHANG Zhiming(Department of Orthopaedic,The Affiliated Hospital of North Sichuan Medical College,Nanchong 637000,Sichuan,China)

机构地区：[1]川北医学院附属医院骨科,四川南充637000

出　　处：《现代医学与健康研究电子杂志》2019年第24期1-4,共4页Modern Medicine and Health Research

摘　　要：目的探讨一期前路病灶清除、取髂骨植骨内固定治疗颈椎间隙化脓性感染的临床疗效。方法选取2014年3月至2018年3月川北医学院附属医院收治的颈椎间隙化脓性感染患者9例为研究对象,均采用一期前路病灶清除、取髂骨植骨内固定治疗。记录手术时间、出血量,观察患者术后1周发热及神经功能改善情况。比较手术前后患者颈部疼痛程度、颈椎功能改善情况以及血WBC、ESR和CRP水平。结果手术时间69~110 min,平均手术时间(84.9±14.2)min;术中出血量45~90 mL,平均术中出血量(67.8±13.5)mL。术后1周发热症状消失,神经功能改善情况:Frankel D级3例,Frankel E级4例。术前、术后VAS评分比较,差异有统计学意义(P<0.05);术后1个月和3个月VAS评分比较,差异有统计学意义(P<0.05)。术前、术后颈椎功能JOA评分比较,差异有统计学意义(P<0.05);术后1个月和3个月JOA评分比较,差异有统计学意义(P<0.05)。术后3个月JOA评分改善率为优7例(77.8%)、良2例(22.2%),优良率为100%。术前、术后血WBC、ESR和CRP水平比较,差异有统计学意义(P<0.05);术后1周和3个月血WBC、ESR、CRP水平比较,差异有统计学意义(P<0.05)。结论一期前路病灶清除、取髂骨植骨内固定联合足量、有效抗菌药物治疗颈椎间隙化脓性感染可以取得良好的临床效果。Objective To investigate the clinical effect of one-stage focus clearance,interbody fusion with ilium and internal fixation via the anterior approach for the treatment of pyogenic infection of cervical intervertebral space.Methods A total of 9 cases suffered from pyogenic infection of cervical intervertebral space admitted to the affiliated hospital of north sichuan medical college from March 2014 to March 2018 were selected as the research object,and were treated by one-stage debridement,interbody fusion with iliac bone and internal fixation via the anterior approach.Operation time and intraoperative blood loss were recorded,and 1 week after operation observed fever and neural function improvement information were observed.Degree of neck pain,improvement of cervical function and levels of WBC,ESR,CRP before and after operation were compared.Results The mean operation time was 84.9±14.2 min(range,69-110min),and on average intraoperative blood loss was 67.8±13.5 mL(range,45-90 mL).1 week after surgery the febrile symptom disappeared and the upgraded circumstance of the neurological function based on the improved Frankel Grade:Frankel D Grade 3 cases,and Frankel E Grade 4 cases.There are statistically significant differences on VAS scores before and after surgery(P<0.05),and there are statistically significant differences on VAS scores 1 month and 3 months after surgery(P<0.05).There are statistically significant differences on JOA cervical vertebra function scores before and after surgery(P<0.05),and there are statistically significant differences on JOA scores 1 month and 3 months after surgery(P<0.05).3 months after surgery the excellent rate of JOA was 77.8%(7 cases),the good rate of JOA was 22.2%(2 cases),and the excellent and good rate of JOA was 100%.There are statistically significant differences on Blood WBC,ESR and CRP levels before and after operation(P<0.05),and There are statistically significant differences on blood WBC,ESR and CRP levels 1 week and 3 months after operation(P<0.05).Conclusion One-st

关 键 词：前路手术 病灶清除术 内固定术 颈椎间隙 化脓性感染 

分 类 号：R687.3[医药卫生—骨科学]