脊柱感染性疾病的规范诊断与治疗  

Standardized diagnosis and treatment of spinal infectious diseases

作　　者：牛宁奎[1] 费骏 贺西京 胡胜平[2] 王立楠 金卫东 王自立[1,3] Niu Ningkui;Fei Jun;He Xijing;Hu Shengping;Wang Linan;Jin Weidong;Wang Zili(Department of Orthopaedics,General Hospital of Ningxia Medical University,Yinchuan 750004,China;Department of Orthopaedics,Hangzhou Chest Hospital,Zhejiang University School of Medicine,Hangzhou 310003,China;Department of Orthopaedics,Xi An International Medical Center Hospital of Northwestern University,Xi'an 710100,China;The Second Affiliated Hospital of Xian Jiaotong University,Xi'an 710004,China)

机构地区：[1]宁夏医科大学总医院脊柱骨科,银川750004 [2]浙江大学医学院附属杭州胸科医院骨科,杭州310003 [3]西北大学附属西安国际医学中心医院脊柱外科,西安710100 [4]西安交通大学第二附属医院,西安710004

出　　处：《中华骨科杂志》2022年第15期968-980,共13页Chinese Journal of Orthopaedics

基　　金：2018年杭州市社会发展科研主动设计项目(20180417A04);国家自然科学基金地区项目(81860395)。

摘　　要：脊柱感染性疾病(infectious diseases of spine,IDS)是指由不同病原微生物引起的脊柱不同部位(椎体、椎间盘、附件、椎管和邻近椎旁组织)的一系列感染性疾病,约占全身骨骼肌肉系统感染的2%~7%。IDS经典分类法可分为特异性感染和非特异性感染两种类型。IDS往往起病隐匿,临床表现不典型,影像学及实验室检查缺乏特异性,对每种疾病的准确诊断及治疗造成很大困扰,常导致漏诊、误诊,甚至是误治。目前临床诊疗程序混乱、治疗方法多样、用药及疗程不规范等问题仍影响着IDS的预后。就目前IDS的诊断和治疗流程的研究进展进行探讨,以期能够进一步规范IDS的诊疗流程。Infectious diseases of spine(IDS)refer to a series of infectious diseases in different parts of the spine(vertebral body,intervertebral disc,appendix of vertebra,spinal canal,and adjacent paravertebral tissues)caused by various pathogenic microorganisms,accounting for about 2%~7%of systemic musculoskeletal system infections.According to the classic classification IDS can be divided into two types:specific infection and non-specific infection.IDS often has an insidious onset,atypical clinical manifestations,and less-specific imaging and laboratory tests,which causes great difficulties for the accurate diagnosis and treatment,often leading to missed diagnosis,misdiagnosis,and even mistreatment.Problems such as disordered clinical diagnosis and treatment procedures,diverse treatment methods,and non-standard medication and course of treatment still affect the prognosis of IDS.This article reviews the current research progress of the diagnosis and treatment process of IDS,in order to further standardize the diagnosis and treatment process of IDS.

关 键 词：感染性疾病 骨骼肌肉系统 特异性感染 IDS 病原微生物 诊疗流程 脊柱 分类法 

分 类 号：R681.5[医药卫生—骨科学]