内镜清创持续灌洗引流治疗胸腰椎化脓性感染  

Endoscopic debridement and continuous lavage and drainage for thoracolumbar suppurative infection

作　　者：李世文 侯宝煜 丁汉忠 刘启 祁全[1] LI Shi-wen;HOU Bao-yu;DING Han-zhong;LIU Qi;QI Quan(Department of Spinal Surgery,The First Affiliated Hospital,Harbin Medical University,Harbin,Heilongjiang 150000,China;The Affiliated Hospital of Qingdao University,Qingdao 266000,China)

机构地区：[1]哈尔滨医科大学附属第一医院,黑龙江哈尔滨150000 [2]青岛大学附属医院,山东青岛266000

出　　处：《中国矫形外科杂志》2025年第2期168-171,共4页Orthopedic Journal of China

摘　　要：[目的]探讨全可视脊柱内镜病灶清除联合持续灌洗引流治疗胸腰椎感染的临床疗效。[方法]回顾性分析本中心2019年1月—2022年10月收治的34例胸腰椎感染伴或不伴脓肿形成患者的临床资料,评价临床、实验室及影像结果。[结果]所有患者均顺利完成手术,无神经、血管损伤等并发症。手术时间平均(120.3±31.4)min、术中失血量平均(31.2±13.5)ml。与术前相比,末次随访时,患者VAS评分[(6.2±0.7),(3.1±1.2),P<0.001]、ODI[(57.4±6.7),(20.4±5.8),P<0.001]均显著减少。术后随时间推移,患者WBC、CRP和ESR均显著降低(P<0.05)。与术前相比,末次随访时,局部后凸Cobb角无显著变化(P>0.05),椎间隙高度[(7.7±1.6)mm,(4.7±3.0)mm,P<0.001]显著降低,病灶活动度[例(活动/静止/愈合),(30/4/0),(0/16/18),P<0.001]显著改善。[结论]全可视脊柱内镜病灶清除联合持续灌洗引流治疗不同病灶位置的胸腰椎感染伴脓肿形成的患者,能够取得较好的临床疗效。[Objective]To investigate the clinical efficacy of endoscopic debridement combined with continuous lavage and drainage for thoracolumbar infection.[Methods]A retrospective study was done on 34 patients who had thoracolumbar infection lesion with or with⁃out abscess formation treated by abovesaid methods in our center from January 2019 to October 2022.The clinical,laboratory and imaging documents were evaluated.[Results]All patients were successfully operated without neurovascular injury and other complications,while with the average operative time of(120.3±31.4)min and blood loss of(31.2±13.5)ml.Compared with those preoperatively,the VAS score[(6.2±0.7),(3.1±1.2),P<0.001]and ODI score[(57.4±6.7),(20.4±5.8),P<0.001]were significantly reduced at the last follow-up.In addi⁃tion,the WBC,CRP and ESR significantly decreased over time(P<0.05).As for imaging,the local kyphotic Cobb angle remained un⁃changed significantly(P>0.05),while the intervertebral height[(7.7±1.6)mm,(4.7±3.0)mm,P<0.001]significantly decreased,and the le⁃sions state[active/static/healed,(30/4/0),(18/0/16),P<0.001]improved significantly at the last follow-up compared with those preoperative⁃ly.[Conclusion]The endoscopic debridement combined with continuous lavage and drainage does achieve satisfactory clinical conse⁃quence for thoracolumbar infection with or without abscess formation at different locations.

关 键 词：全可视脊柱内镜 脊柱感染 硬膜外脓肿 椎间盘炎 椎旁脓肿 灌洗引流术 

分 类 号：R687[医药卫生—骨科学]