抗生素人工骨结合自体骨植入联合病灶清除联合CBT螺钉内固定治疗腰椎椎间隙感染的效果  

Clinical Study of Antibiotic Artificial Bone and Autologous Bone Implantation Combined with Lesion Removal and CBT Screw Internal Fixation in the Treatment of Lumbar Intervertebral Space Infection

作　　者：陈洪柱 林松 陈钱 吴强 CHEN Hongzhu;LIN Song;CHEN Qian;WU Qiang(The Second Department of Spine Surgery,Luoyang Orthopedic-Traumatological Hospital of Henan Province/Henan provincial Orthopedic Hospital,Zhengzhou 450000,China)

机构地区：[1]河南省洛阳正骨医院/河南省骨科医院脊柱外二科,河南郑州450000

出　　处：《河南医学研究》2023年第22期4107-4111,共5页Henan Medical Research

摘　　要：目的 探讨抗生素人工骨结合自体骨植入联合病灶清除联合皮质骨钉道(CBT)螺钉内固定治疗腰椎椎间隙感染(LISI)的临床疗效。方法 选取2020年1月至2022年12月医院收治的120例LISI患者,采用随机数字表法分为A组和B组,各60例。A组接受抗生素人工骨结合自体骨植入联合病灶清除联合CBT螺钉内固定治疗,B组接受自体骨植入联合病灶清除联合CBT螺钉内固定治疗。比较两组感染病原菌菌种分布、手术时间、术中出血量、术后引流持续时间、抗生素应用时间和住院时间;比较两组疼痛视觉模拟法(VAS)评分、日本骨科协会腰椎功能(JOA)评分、腰椎功能障碍指数(ODI)评分、红细胞沉降率(ESR)、血清C反应蛋白(CRP)水平和病变椎体节段后凸Cobb角及并发症发生率。结果 120例LISI患者术后细菌培养共检出病原菌110株,两组LISI患者感染病原菌菌种差异无统计学意义(P>0.05)。A组手术时间长于B组,抗生素使用时间和住院时间短于B组(P<0.05)。术后1、6个月,A组VAS评分、ODI评分、ESR和CRP水平低于B组,JOA评分高于B组(P<0.05)。术后3个月A组Cobb角低于B组(P<0.05),但术后6个月两组Cobb角差异无统计学意义(P>0.05)。两组并发症发生率差异无统计学意义(P>0.05)。结论 抗生素人工骨结合自体骨植入联合病灶清除联合CBT螺钉内固定治疗LISI的效果确切,可缩短病程,缓解患者疼痛,促进腰椎功能恢复。Objective To explore the clinical curative effect of antibiotic artificial bone and autologous bone implantation combined with lesion removal and cortical bone trajectory(CBT)screw internal fixation on lumbar intervertebral space infection(LISI).Methods A total of 120 LISI patients admitted to the hospital from January 2020 to December 2022 were selected and randomly divided into group A and group B using random number table method,with 60 patients in each group.Group A received antibiotic artificial bone combined with autologous bone implantation combined with lesion clearance and CBT screw internal fixation treatment,while Group B received autologous bone implantation combined with lesion clearance and CBT screw internal fixation treatment.The distribution of infectious pathogens,operation time,intraoperative blood loss,postoperative drainage duration,usage time of antibiotics and hospitalization time,scores of visual analogue scale(VAS),Japanese orthopaedic association(JOA),Oswestry disability index(ODI),levels of erythrocyte sedimentation rate(ESR)and serum C-reactive protein(CRP),Cobb angle of kyphotic vertebral segment,incidence of complications were compared between the two groups.Results A total of 110 strains of pathogenic bacteria were detected in postoperative bacterial culture of 120 LISI patients,and there was no statistically significant difference in the bacterial species of infection between the two groups of LISI patients(P>0.05).The surgical time in group A was longer than that in group B,and the use of antibiotics and hospitalization time were shorter than those in group B(P<0.05).At 1 and 6 months after surgery,the VAS score,ODI score,ESR,and CRP levels in group A were lower than those in group B,while the JOA score was higher than that in group B(P<0.05).The Cobb angle in group A was lower than that in group B at 3 months after surgery(P<0.05),but there was no statistically significant difference in Cobb angle between the two groups at 6 months after surgery(P>0.05).There was no statistically

关 键 词：抗生素人工骨 自体骨植入 病灶清除 皮质骨钉道螺钉内固定 腰椎椎间隙感染 

分 类 号：R274.34[医药卫生—中医骨伤科学]