| 椎间隙灌洗法治疗腰椎后路内固定术后切口早期深部感染的疗效分析 |
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Received:May 18, 2012
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| 作者 | Author | 单位 | Unit | E-Mail |
| 刘昱彰 |
LIU Yu-zhang |
中国中医科学院望京医院脊柱一科,北京 100102 |
Department of the First Spinal Surgery,Wangjing Hospital of China Academy of Chinese Medical Sciences,Beijing 100102,China |
liuyuzhang73@yahoo.com |
| 张世民 |
ZHANG Shi-min |
中国中医科学院望京医院脊柱一科,北京 100102 |
Department of the First Spinal Surgery,Wangjing Hospital of China Academy of Chinese Medical Sciences,Beijing 100102,China |
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| 董福慧 |
DONG Fu-hui |
中国中医科学院望京医院脊柱一科,北京 100102 |
Department of the First Spinal Surgery,Wangjing Hospital of China Academy of Chinese Medical Sciences,Beijing 100102,China |
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| 周卫 |
ZHOU Wei |
中国中医科学院望京医院脊柱一科,北京 100102 |
Department of the First Spinal Surgery,Wangjing Hospital of China Academy of Chinese Medical Sciences,Beijing 100102,China |
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| 李星 |
LI Xing |
中国中医科学院望京医院脊柱一科,北京 100102 |
Department of the First Spinal Surgery,Wangjing Hospital of China Academy of Chinese Medical Sciences,Beijing 100102,China |
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| 张禄堂 |
ZHANG Lu-tang |
中国中医科学院望京医院脊柱一科,北京 100102 |
Department of the First Spinal Surgery,Wangjing Hospital of China Academy of Chinese Medical Sciences,Beijing 100102,China |
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| 章永东 |
ZHANG Yong-dong |
中国中医科学院望京医院脊柱一科,北京 100102 |
Department of the First Spinal Surgery,Wangjing Hospital of China Academy of Chinese Medical Sciences,Beijing 100102,China |
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| 黎作旭 |
LI Zuo-xu |
中国中医科学院望京医院脊柱一科,北京 100102 |
Department of the First Spinal Surgery,Wangjing Hospital of China Academy of Chinese Medical Sciences,Beijing 100102,China |
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| 吴冠男 |
WU Guan-nan |
中国中医科学院望京医院脊柱一科,北京 100102 |
Department of the First Spinal Surgery,Wangjing Hospital of China Academy of Chinese Medical Sciences,Beijing 100102,China |
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| 张兆杰 |
ZHANG Zhao-jie |
中国中医科学院望京医院脊柱一科,北京 100102 |
Department of the First Spinal Surgery,Wangjing Hospital of China Academy of Chinese Medical Sciences,Beijing 100102,China |
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| 马明 |
MA Ming |
中国中医科学院望京医院脊柱一科,北京 100102 |
Department of the First Spinal Surgery,Wangjing Hospital of China Academy of Chinese Medical Sciences,Beijing 100102,China |
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| 期刊信息：《中国骨伤》2012年25卷，第10期，第866-869页 |
| DOI：10.3969/j.issn.1003-0034.2012.10.020 |
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目的：探讨腰椎内固定术后切口早期深部感染的原因、诊断要点及治疗手段.
方法：自2001年1月至2011年12月,对10例采用椎间隙灌注冲洗法治疗的腰椎后路内固定术后切口早期深部感染患者的临床资料进行回顾性分析.其中男1例,女9例;平均年龄63岁,感染发病时间平均为术后第6天.主要临床表现包括不同程度腰腿痛加重、体温升高、伤口新鲜渗液及血炎性指标增高等,疗效评估则以伤口是否Ⅰ期愈合为主要标准.
结果：10例患者均获得随访,随访时间平均为1年5个月.9例伤口Ⅰ期愈合,无复发,也无术后并发症出现,1例患者后续进行多次清创术,疗程共7个月,最后将椎弓根螺钉取出后伤口愈合,随访1.5年未复发.
结论：腰椎内固定术后深部感染尽早行手术清创及椎间隙灌注冲洗法治疗,可获得满意疗效并能最终保留内固定,避免过多切除软组织及椎间隙深层置管是手术成功的关键. |
| [关键词]:腰椎 外科手术 手术后并发症 感染 灌注,局部 |
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| Analysis of curative effect of the intervertebral space lavaging for the treatment of incisions deep infections at early stage after posterior lumber internal fixation |
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Abstract:
Objective:To explore the reason,diagnose outline,therapeutic tool of the incisions deep infections at early stage after lumber internal fixation.
Methods:From January 2001 to December 2011,10 patients with incisions deep infections at the early stage after the posterior lumber internal fixation were treated with intervertebral space lavaging. There were 1 male and 9 females with an average age of 63 years,and an average infection started at the 6th day after operation. The main clinical features including backleg pain aggravating,fervescence,fresh seepage from the wound,and blood inflammatory index increased,etc. According to whether the wound could heal at the first treatment stage as a evaluation standard of curative effect.
Results:Ten cases were followed up with an average period of 17 months. The wounds of 9 cases healed at the first stage and no recurrence and complications were found. One case underwent debridgement of many times with the therapic period of 7 months,at last,after taking out the vertebral pedicle bolt,the wound healed,and no recurrence after follow-up of 18 months.
Conclusion:The deep wound infections after the lumber internal fixation should receive intervertebral space lavaging as soon as possible. The method can finally remain internal fixations and obtain satisfactory effects,but avoiding too much tissue cutting and tube setting in the deep intervertebral space are the keys to the successful fixation. |
| KEYWORDS:Lumbar vertebrae Surgical procedures,operative Postoperative complication Infection Perfusion,regional |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 刘昱彰,张世民,董福慧,周卫,李星,张禄堂,章永东,黎作旭,吴冠男,张兆杰,马明.椎间隙灌洗法治疗腰椎后路内固定术后切口早期深部感染的疗效分析[J].中国骨伤,2012,25(10):866~869 |
| 英文格式: | LIU Yu-zhang,ZHANG Shi-min,DONG Fu-hui,ZHOU Wei,LI Xing,ZHANG Lu-tang,ZHANG Yong-dong,LI Zuo-xu,WU Guan-nan,ZHANG Zhao-jie,MA Ming.Analysis of curative effect of the intervertebral space lavaging for the treatment of incisions deep infections at early stage after posterior lumber internal fixation[J].zhongguo gu shang / China J Orthop Trauma ,2012,25(10):866~869 |
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