| 椎管内感染的分析与探讨 |
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投稿时间：2005-02-01
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| 作者 | Author | 单位 | Address | E-Mail |
| 端木群力 |
DUANMU Qun-li |
浙江中医学院附属杭州第三医院骨科,310009,浙江杭州 |
The 3th Affiliated Han gzhou Hospital of Zhejiang College of TCM,Hangzhou 310009,Zhejiang,China |
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| 刘新功 |
LIU Xin-gong |
浙江中医学院附属杭州第三医院骨科,310009,浙江杭州 |
The 3th Affiliated Han gzhou Hospital of Zhejiang College of TCM,Hangzhou 310009,Zhejiang,China |
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| 黄东辉 |
HUANG Dong-hu i |
浙江中医学院附属杭州第三医院骨科,310009,浙江杭州 |
The 3th Affiliated Han gzhou Hospital of Zhejiang College of TCM,Hangzhou 310009,Zhejiang,China |
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| 殷浩 |
YIN Hao |
浙江中医学院附属杭州第三医院骨科,310009,浙江杭州 |
The 3th Affiliated Han gzhou Hospital of Zhejiang College of TCM,Hangzhou 310009,Zhejiang,China |
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| 赵琦辉 |
ZHAO Qi-hui |
浙江中医学院附属杭州第三医院骨科,310009,浙江杭州 |
The 3th Affiliated Han gzhou Hospital of Zhejiang College of TCM,Hangzhou 310009,Zhejiang,China |
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| 期刊信息：《中国骨伤》2005年，第18卷，第9期，第521-523页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
| 基金项目: |
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中文摘要:
目的:探讨腰椎椎管内感染的临床症状及相关性分析和治疗效果。
方法:回顾性分析1985年2月-2004年4月,15例腰椎椎管内感染的临床症状、体征、实验室检验和治疗效果。腰间盘突出症术后感染9例,椎弓根螺钉内固定术后1例,椎管减压术后2例,腰椎压缩性骨折后2例（保守治疗）,硬膜外药物注射治疗1例。不明细菌感染12例,结核杆菌感染2例（抗结核治疗有效）,霉菌感染1例（病理检查证实）。分别给予广谱抗生素治疗、抗结核治疗和抗霉菌治疗。
结果:本组随访5个月~14年,9例腰腿痛症状完全消失,4例劳累后经常复发腰腿痛,1例常复发腰腿痛,生活完全能自理,1例不能参加工作,生活能自理,在家休养至今7年余。按腰椎术后日本N.Nakano和T.Nakano功能评定标准:优9例,良4例,可2例。
结论:涉及椎管的疾病在保守治疗过程中或病人创伤后,出现腰腿痉挛性、阵发性抽痛是腰椎椎管内感染的最早体征,可作为早期诊断的主要依据。结合血沉明显增高及磁共振的表现,则可明确诊断。广谱的、有效的或针对性（经病理检查或诊断性用药有效）、足量地、持续地抗生素应用效果理想。 |
| 【关键词】腰椎 椎管 感染 诊断 治疗方案 |
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| Analysis and study on intraspinal infection |
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ABSTRACT
Objective: To explore the symptoms and therapeutic effects of intraspinal infection of lumb ar vertebrae.
Methods: Clinical symptoms and signs,lab test and therapeutic effects of 15 patients with intraspinal infections treated from 198 52 to 20044 were reviewed.Postoperativ e infection occurred in 12 patients,includ ing the operation for treatment of lumb ar disc herniation(9 pati ents),pedicle screw fixation operation(1 patient) and lumbar vertebral compressi on operation(2 patients).Intraspinal inf ections were found in 2 patients after c onservative treatment for compressive fr actures of lumbar vertebrae and 1 patien t after performing peridural drug inject ion.The infections were caused by Mycob acterium tuberculosis (2 patients),mycet e(1 patient)and unidentified bacteria(12 patients).Antituberculin,antimycotic an d broad-spectrum antibiotic were used re spectively in this study.
Results: After 5 months to 14 years follow-up,th e waist and leg pain disappeared complet ely in 9 pa tients,the pain disappeared but often r eoccurred induced by tiredness in four patients. One patient was no t able to participate in job and had bee n at home for 7 years,but he could take care of himself.According to the criteri a of N.Nakano and T.Nakano,9 cases achie ved excellent results,4 good and 2 poor.
Conclusion: Usually,the spasticcity and paroxysmal p ain of waist and leg is early physical s igns of intraspinal infection of lumbar vertebrae,which can be used as main evid ence to diagnosis this disease.Fast sedi mentation rate(ESR)and MR exa m ination are helpful to antibiotic dia gnosis.Satisfactory clinical results wi l l be obtained by using effective and bro ad spectrum sufficiently,continuously an d directly. |
| KEY WORDS Lumbar vertebrae Spinal canal Infection Diagnosis Treatment protocols |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 端木群力,刘新功,黄东辉,殷浩,赵琦辉.椎管内感染的分析与探讨[J].中国骨伤,2005,18(9):521~523 |
| 英文格式: | DUANMU Qun-li,LIU Xin-gong,HUANG Dong-hu i,YIN Hao,ZHAO Qi-hui.Analysis and study on intraspinal infection[J].zhongguo gu shang / China J Orthop Trauma ,2005,18(9):521~523 |
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