镜下融合技术治疗腰椎间隙非特异性感染的临床研究  

Clinical study of endoscopic fusion technique for treatment of lumbar intervertebral non-specific infection

作　　者：黄立 李枝发 刘万祥[1] 黄民锋[1] 闫乾[1] 陈锋[1] HUANG Li;LI Zhifa;LIU Wanxiang;HUANG Minfeng;YAN Qian;CHEN Feng(Department of Spinal Surgery,Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine,Nanning 530011,Guangxi,China)

机构地区：[1]广西中医药大学附属瑞康医院脊柱外科,广西南宁市530011

出　　处：《微创医学》2023年第3期300-305,共6页Journal of Minimally Invasive Medicine

基　　金：国家自然科学基金(编号:81960879);广西自然科学基金项目(编号:2021GXNSFAA220089);中华预防医学会科研资金支持项目(编号:20190224);广西区中医药管理局中药壮瑶药医院制剂质量提升项目(编号:GZZJ202008)。

摘　　要：目的探讨镜下融合技术治疗单节段腰椎间隙非特异性感染的可行性、安全性、有效性及临床疗效。方法选取采用镜下融合技术治疗的20例单节段腰椎间隙非特异性感染患者为研究对象,记录患者的手术情况(手术时间、术中出血量、术中及术后并发症情况)、术后恢复指标[VAS评分、Oswestry功能障碍指数(ODI)评分]、感染指标(白细胞计数、中性粒细胞百分比、红细胞沉降率、C反应蛋白、降钙素原)、手术前后腰椎前凸角、手术前后椎间隙高度、临床疗效及随访情况等。结果本组20例患者的手术时间为(164.00±17.51)min,术中出血量为(76.75±14.35)mL;术中、术后均未出现明显的并发症。术后6个月腰椎前凸角为(26.00±8.14)°,明显高于术前的(21.85±6.60)°,差异有统计学意义(P<0.05);术后6个月椎间隙高度为(9.65±3.25)mm,明显高于术前的(7.92±2.52)mm,差异有统计学意义(P<0.05)。术后2个月,按改良MacNab疗效评定标准,优10例、良9例、可1例、差0例,优良率为95.00%。术后1周,患者的VAS评分、ODI评分、降钙素原水平较术前降低,中性粒细胞百分比、C反应蛋白水平较术前升高,差异均有统计学意义(均P<0.05);而白细胞计数、血沉与术前差异均无统计学意义(均P>0.05)。术后2周,患者的VAS评分、ODI评分、白细胞计数、中性粒细胞百分比、降钙素原水平较术前及术后1周降低,差异均有统计学意义(均P<0.05);而血沉、C反应蛋白水平与术前相比,差异均无统计学意义(均P>0.05);术后2周,C反应蛋白水平低于术后1周,差异有统计学意义(P<0.05)。术后1个月,患者的VAS评分、ODI评分、白细胞计数、中性粒细胞百分比、C反应蛋白、血沉、降钙素原水平较术前、术后1周、术后2周降低,差异均有统计学意义(均P<0.05)。术后2个月,患者的ODI评分、白细胞计数、中性粒细胞百分比、C反应蛋白水平、血沉、降钙素原水平较术Objective To investigate the feasibility,safety,efficiency and clinical efficacy of endoscopic fusion technique in the treatment of single-segment lumbar intervertebral non-specific infection.Methods Twenty patients with single-segment lumbar intervertebral non-specific infection treated by endoscopic fusion technique were selected as the research objects.The patients'operation conditions(operation time,intraoperative blood loss,intraoperative and postoperative complications),postoperative recovery indicators(VAS score,Oswestry disability index[ODI]score),infection indicators(white blood cell count,neutrophil percentage,erythrocyte sedimentation rate,C-reactive protein,procalcitonin),preoperative and postoperative lumbar lordotic angle,preoperative and postoperative lumbar intervertebral space height,clinical efficacy and follow-up data were recorded.Results The operation time of the 20 patients was(164.00±17.51)min and the intraoperative blood loss was(76.75±14.35)mL.There were no obvious complications during and after operation.The lumbar lordotic angle was(26.00±8.14)°at 6 months after operation,which was significantly higher than that before operation(21.85±6.60)°,with statistically significant difference(P<0.05).The height of the intervertebral space at 6 months after operation was(9.65±3.25)mm,which was significantly higher than that before operation(7.92±2.52)mm,with statistically significant difference(P<0.05).Two months after operation,according to the modified MacNab efficacy evaluation standard,there were 10 cases of excellent,9 cases of good,1 case of fair,0 cases of poor,with an excellent and good rate of 95.00%.One week after operation,the VAS score,ODI score and procalcitonin level were lower than those before operation,while the neutrophil percentage and C-reactive protein level were higher than those before operation,with statistically significant differences(all P<0.05).There were no statistically significant differences in the white blood cell count and erythrocyte sedimentation rate be

关 键 词：脊柱内镜 融合 腰椎 椎间隙非特异性感染 疗效 

分 类 号：R681.5[医药卫生—骨科学]