腰椎内固定术后感染关于腰椎内固定器械移除或保留的治疗进展  

Management progress of the implant removal or retention for the surgical site infection after lumbar internal fixation

作　　者：黄于锋 陈立启[1] 郭虎兵[1] 刘瑾[1] 盛俊东[1] 王军文 于新福[1] 孙金琳 王军全 王江峰 HUANG Yu-feng;CHEN Li-qi;GUO Hu-bing;LIU Jin;SHENG Jun-dong;WANG Jun-wen;YU Xin-fu;SUN Jin-lin;WANG Jun-quan;WANG Jiang-feng(Department of Orthopaedics,Tianshui First People's Hospital,Tianshui,Gansu,741000,China)

机构地区：[1]天水市第一人民医院骨科一病区,甘肃省741000

出　　处：《中国骨与关节杂志》2025年第1期78-82,共5页Chinese Journal of Bone and Joint

摘　　要：手术部位感染(surgical site infection,SSI)是脊柱术后常见并发症之一,发生率约为0.4%~6.9%[1]。腰椎内固定术后感染的主要处理原则为外科清创联合长期抗生素治疗,外科清创可以清除感染病灶周围的脓液、坏死组织以及附着于腰椎内固定器械表面的炎性肉芽组织,进而进行伤口持续冲洗,必要时行负压引流,降低感染部位的细菌和毒素浓度,最终有效控制感染。Lumbar internal fixation is widely used in many fields such as degenerative diseases,trauma and deformity of the lumbar spine.With the growth of the number of operations,the incidence of surgical site infection after lumbar internal fixation is also increased.Implant removal or retention is critical to the management of infection after lumbar internal fixation.At present,there is no guideline for the selection.By referring to the domestic and foreign literature on the treatment of infection after lumbar internal fixation,the removal rate and time,advantages and disadvantages of retention and treatment progress are analyzed and summarized.Implant removal or retention are both common in clinical practice,however,both methods have their own shortcomings,such as spinal instability,pseudarthrosis and nervous lesions.In this study,the incidence of infection after lumbar internal fixation,the rate of implant removal or retention and the common bacterial genus are summed up to compare the advantages and disadvantages of implant removal or retention,and the management measures.The aim is to provide ideas for the rational disposal of implant in the management of surgical site infection after lumbar internal fixation.

关 键 词：内固定器 腰椎 感染 综述 

分 类 号：R681.2[医药卫生—骨科学]