| 椎间隙感染的诊断与治疗进展 |
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Received:December 16, 2015
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| 作者 | Author | 单位 | Unit | E-Mail |
| 朱小龙 |
ZHU Xiao-long |
浙江中医药大学第二临床医学院, 浙江 杭州 310051 |
Department of Orthopaedics, Tongde Hospital of Zhejiang Province, Hangzhou 310012, Zhejiang, China |
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| 徐卫星 |
XU Wei-xing |
浙江省立同德医院骨科, 浙江 杭州 310012 |
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xwx.spine@163.com |
| 刘杰 |
LIU Jie |
浙江中医药大学第二临床医学院, 浙江 杭州 310051 |
Department of Orthopaedics, Tongde Hospital of Zhejiang Province, Hangzhou 310012, Zhejiang, China |
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| 期刊信息：《中国骨伤》2016年29卷，第9期，第870-874页 |
| DOI：10.3969/j.issn.1003-0034.2016.09.020 |
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| 随着椎间盘摘除手术的广泛开展，椎间隙感染发病率有明显增高的趋势，由于缺乏诊断特异性指标，早期诊断困难，容易出现漏诊误诊，椎间盘穿刺取样微生物培养是抗生素选择的金标准，但其阳性检出率有待于提高，目前，不同医疗机构间存在流行病学、治疗经验的差异，抗生素的选择、用药疗程及手术的方式都尚未形成统一的认识。近几年，磁共振成像、18氟-脱氧葡萄糖正电子发射计算机断层扫描、影像学介导下经皮椎间盘穿刺、经皮脊椎内窥镜病灶清除+灌洗引流术、后路经皮内固定联合前路小切口等的广泛应用为早期诊断和治疗提供了更多选择。椎间隙感染应重视预防、早期诊断、尽早明确致病菌，治疗应结合医生自身的经验和患者实际情况选择合适的治疗方案，治疗过程中应密切监测实验室指标、及时调整治疗方案，并通过辅助治疗以缩短治疗时间、预防其他并发症发生。 |
| [关键词]:椎间隙 感染 诊断 治疗 综述文献 |
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| Research and progress on diagnosis and treatment of intervertebral space infection |
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| Abstract:As the disc surgery were extensively developed,the incidence of intervertebral space infection was significantly increased. Due to a lack of specificity,early diagnosis is difficult and it is prone to misdiagnose. Intervertebral disc puncture sampling microorganism culture is a gold standard of antibiotic selection,but the positive detection rate needs to be improved. At present,different medical institutions have different opinious in epidemiology,treatment experiences,the choice of antibiotic treatment,the course of treatment and the way of operation. In recent years,magnetic resonance imaging,fluorine-deoxidization glucose positron emission computed tomography scanning,the imaging application mediated percutaneous intervertebral disc,spinal puncture percutaneous endoscopic debridement and lavage drainage and percutaneous internal fixation combined with anterior posterior incision provide more choices for early diagnosis and treatment. Intervertebral infection should attract more attention to the prevention,early diagnosis,early specific pathogens. Doctors' experience and patients' actual situation should be considered when choosing a appropriate treatment. During the treatment,we should be closely monitored laboratory indexes and timely adjust plan of the treatment,and shorten the treatment time and prevent other complications through the auxiliary treatment. |
| KEYWORDS:Intervertebral space Infection Diagnosis Treatment Review literature |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 朱小龙,徐卫星,刘杰.椎间隙感染的诊断与治疗进展[J].中国骨伤,2016,29(9):870~874 |
| 英文格式: | ZHU Xiao-long,XU Wei-xing,LIU Jie.Research and progress on diagnosis and treatment of intervertebral space infection[J].zhongguo gu shang / China J Orthop Trauma ,2016,29(9):870~874 |
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