摘要
目的探究脊柱后路术后感染的临床分析及诊治对策,以有效控制术后感染。方法选取2006年5月-2010年3月脊柱后路手术患者395例,按照其是否感染分为感染组与非感染组,探讨两组临床检验指标(血白细胞、血沉、C-反应蛋白水平)及治疗效果差异,分析术后感染的诊治对策;采用SPSS13.0进行分析。结果术前两组患者血白细胞、血沉及C-反应蛋白水平均处于正常范围,术后临床检验指标2个月非感染组无明显变化,感染组患者均有升高,两组数据对比差异有统计学意义;治疗后感染组优18例、良20例,优良率74.5%,非感染组优147例、良158例,优良率88.7%,感染组治疗效果明显低于非感染组;感染组51例患者均获得有效随访,无复发感染,迟发型感染患者出现1例内固定松动,发生率6.25%。结论脊柱后路术后感染主要由创口挫伤出血、内固定不稳造成,患者多出现发热、化脓等症状,血白细胞、血沉及C-反应蛋白水平显著增加;对于急性感染及迟发性感染患者分别采取适当的治疗方法,能够有效控制感染,预防复发,提高患者生活质量。
OBJECTIVE To analyze the infections after posterior spinal surgery and put forward diagnosis and treatment measures so as to effectively control the postoperative infections. METHODS A total of 395 patients. who underwent the posterior spinal surgery in the hospital from May 2006 to Mar 2010, were enrolled in the study and divided into the infection group and the non-infection group, then the clinical laboratory indicators （white blood cells, erythrocyte sedimentation rate, C-reactive protein） and therapeutic effect were observed, the diagnosis and treatment measures for the postoperative infections were analyzed, and the statistical analysis was performed. RESULTS The levels of white blood cells, erythrocyte sedimentation rate, and C-reactive proteins of both groups were within a normal range before the surgery; two months after the surgery, the levels of the clinical laboratory indicators of the non-infection group did not change significantly, of which the infection group were elevated, the differences between the two groups were not statistically significant. After the treatment, there were 18 cases of excellence and 20 cases of good with the excellent and good rate of 74. 5% in the infection group; there were 147 cases of excellence and 158 cases of good with the excellent and good rate of 88. 7 %, the therapeutic effect of the infection group was significantly lower than that of the non-infection group. Totally 51 patients in the infection group have acquired the effective follow-up, which showed no case of recurrent infections and 1 case of internal fixation loosening among the cases of delayed infections with the incidence rate of 6. 25 %. CONCLUSION The wound contusion hemorrhage and instability of internal fixation are the major causes of the infections after the posterior spinal surgery, most of the patients are complicated with the symptoms such as fever and purulency, and the levels of WBC, ESR, and CRP are significantly elevated; suitable treatment measures should be taken for the patients with acute infections or delayed infections so as to effectively control the infections, prevent the recurrence, and improve the quality of life of the patient.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2014年第5期1207-1208,1211,共3页
Chinese Journal of Nosocomiology
基金
河南省医学科技攻关计划基金项目(201303216)
关键词
脊柱后路手术
感染
分析
诊断
治疗
Posterior spinal surgery
Infection
Analysis
Diagnosis
Treatment
