腰椎间盘突出症术后椎间盘炎的临床分析及其预防  

The Clinnical Analysis and Treatment of Discitis after Operation for Lumbar Disc Herniation(LDH)

作　　者：臧晓方[1] 王丽玲[1] 周勇[1] 李小如[1] 

机构地区：[1]中南大学湘雅三医院骨科,中国湖南长沙410013

出　　处：《实用预防医学》2003年第3期336-338,共3页Practical Preventive Medicine

摘　　要：目的　分析 LDH术后出现椎间盘炎的原因和临床表现 ,探讨有效的预防和治疗方法。　方法　对 1 1例椎间盘炎患者的临床表现、实验室检查、细菌培养和 CT、MRI等进行回顾性分析。 3例患者经手术病灶清除、灌洗引流术 ,其余9例行保守治疗 ,均予以制动、理疗和大剂量抗生素静脉应用。　结果　 1 1患者在椎间盘手术后 7～ 30 d出现症状 ,平均1 5 d。本症有典型症状 ,包括腰部的痉挛性疼痛 ,体位改变时加重 ,伴血沉升高 ,经治疗后患者疼痛缓解或消失 ,3例手术患者病灶内培养出低毒力性皮肤正常菌群。　结论　椎间盘炎是由初次手术中术中污染引起的椎间隙的感染 ,确诊后经保守治疗或手术治疗 ,均有满意疗效 ,但历时较长 。Objective To study the cause and the clinical presentations of discitis after LDH operation,find out effective prevention and treatment ways for this complication. Methods 11 cases of discitis following LDH operation were reviewed.Clinical symptoms,laboratory tests,bacteria culture reports,CT and MRI were studied.3 cases were operated with debridement and irrigation.9 cases were only treated by unmovement,physical treatment and a great dose of antibiotics. Result These 11 patients experienced development of discitis in 7-30days(a mean of 15 days) after the initial procedure.The clinical presentations were obvious,all reported spastic back pain and elevated erythrocyte sedimentation rate.All patients gained relief of back pain after treatment.Low-virulence normal organisms were yielded in 3 cases with general culture. Conclusion Discitis may have been caused by intraoperative contamination.It can be successfully treated by many ways,but it will last a long time.Prevention is of the most importance.

关 键 词：腰椎间盘突出症 手术后并发症 椎间盘炎 预防和治疗 

分 类 号：R681.53[医药卫生—骨科学]