通道下病灶清除、间隙内载药硫酸钙骨粒植入联合经皮固定治疗脊柱感染
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滨州医学院烟台附属医院

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国家自然科学基金项目(面上项目,重点项目,重大项目)


Treatment of spinal infection with percutaneous fixation, quadrant channel debridement and calcium sulfate bone powder combined with sensitive antibiotics
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滨州医学院烟台附属医院

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    摘要:

    【摘 要】目的 分析通道下病灶清除联合载药硫酸钙骨粒间隙内植入、经皮固定治疗脊柱感染的疗效。方法 收集2015年7月至2018年12月在我科行通道下病灶清除联合载药硫酸钙骨粒间隙内植入、经皮固定手术的18例患者的临床资料,记录患者住院时间、手术时间、术中失血量、手术前、术后7天、末次随访的血沉、CRP、ODI、VAS评分、Cobb角、临床疗效,比较术前、术后7天、末次随访的血沉、CRP、ODI、VAS、Cobb角变化,通过统计学分析差异显著性。结果 本组的18例患者均顺利完成手术,男8例,女10例,年龄46-75岁,平均年龄56岁,随访时间为术后8-18个月(平均12个月)。经统计学分析,末次随访时患者ODI、VAS评分、血沉及C-反应蛋白均显著优于术前,差异有显著性意义(P < 0.05)。Cobb角较术前无显著性差异。结论 脊柱感染患者,通道下病灶清除、硫酸钙抗生素骨粒植入、经皮固定手术是一种比较理想的治疗方法,维持稳定同时保持局部有效抗生素浓度,利于控制感染,提高生活质量。

    Abstract:

    Abstract:Objective To investigate the effect of clinical treatment of spinal infection with percutaneous fixation,quadrant channel debridement and calcium sulfate bone powder combined with sensitive antibiotics.Methods 18 cases of spinal infection patients who underwent percutaneous fixation,quadrant channel debridement and calcium sulfate bone powder combined with sensitive antibiotics were studied from July 2015 to December 2018. We collected the data including the operation time、 bleeding volume、hospitalization time、function examination、erythrocyte sedimentation rate (ESR)、C-reactive protein(CRP)、Oswestry Disability Index(ODI)、Visual analog scale(VAS) before the surgery and 7 days\last follow-up after the treatment,analysis the significant difference between the datas by statistics.Results 18 cases of the department were treated by percutaneous fixation, quadrant channel debridement and calcium sulfate bone powder combined with sensitive antibiotics.All cases were get followed,follow-up period was 8-18 months,there were 8 males and 10 females and the mean age was 56 years, ESR\CRP\ODI\VAS scores were significantly better in final follow-up than that pre-treatment (P < 0.05). The average Cobb angle of lesion segment was no statistical difference. Conclusion It is an ideal treatment for the patients with spinal infection by percutaneous fixation, quadrant channel debridement and calcium sulfate bone powder combined with sensitive antibiotics. Maintain the stability and local effective antibiotic concentration, which is beneficial to control infection. And improve the quality of life.

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  • 收稿日期:2019-09-02
  • 最后修改日期:2019-11-18
  • 录用日期:2019-12-02
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