保留内固定治疗胸腰椎术后感染体会.docVIP

保留内固定治疗胸腰椎术后感染的体会 　　[摘要] 目的 探讨在保留内固定情况下，经过换药、病灶清除、扩创引流及使用敏感抗生素等一系列治疗手段，治愈胸腰椎术后感染的可行性。 方法 回顾性分析2012年1月～2015年5月合肥市第二人民医院收治的16例胸腰椎术后感染患者临床资料。在保留内固定情况下，经过一系列换药、扩创、冲洗引流及使用敏感抗生素等积极治疗，观察切口愈合情况。对比分析治疗前后白细胞（WBC）计数、血沉（ESR）、C-反应蛋白（CRP）及疼痛视觉模拟评分法（VAS）评分。 结果 所有患者切口愈合良好。随访6个月～2年，无患者复发。治疗后WBC计数、ESR、CRP及VAS评分均较治疗前降低，差异有统计学意义（P 0.05）。 结论 应早期明确诊断胸腰椎术后感染，及时积极采取换药、病灶清除、冲洗引流等积极治疗，在保留内固定的情况下，也可获得良好效果。 　　[关键词] 胸腰椎；内固定；治疗；白细胞计数；血沉；C-反应蛋白 　　[中图分类号] R681.530 [文献标识码] A [文章编号] 1673-7210（2018）01（c）-0081-04 　　[Abstract] Objective To explore the feasibility of treating postoperative infection of thoracolumbar spine in the case of retaining internal fixation with a series of treatment methods， such as changing drugs， removing the lesion， expanding the drainage and using sensitive antibiotics. Methods The clinical data of 16 patients with postoperative infection of thoracolumbar spine treated in the Second Peoples Hospital of Hefei from January 2012 to May 2015 were analyzed retrospectively. In the case of retaining internal fixation， after a series of treatment methods， such as changing drugs， removing the lesion， expanding the drainage and using sensitive antibiotics， the wound healing was observed. The white blood cell （WBC） number， erythrocyte sedimentation rate （ESR）， C-reactive protein （CRP） and visual analogous scale （VAS） were analyzed and compared before and after treatment. Results All patients wound healing were well. Follow-up time was from 6 months to 2 years， and no case recurred. After treatment， the WBC number， ESR， CRP and VAS score were lower than those before treatment， with statistically significant difference （P 0.05）. Conclusion It is necessary to clearly diagnose the postoperative infection of thoracolumbar spine in the early stage， and actively take the active treatment， such as changing drugs， removing the lesion， washing the drainage， etc. In the case of retaining internal fixation， it can also achieve good curative effect. 　　[Key words] Thoracolumbar spine； Intern