经皮内镜下清创冲洗术治疗腰椎间隙非特异性感染的临床疗效
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河南省人民医院

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Clinical efficacy of percutaneous endoscopic debridement and drainage for non-specific lumbar intervertebral infection
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1.Henan Provincal People´2.s Hospital

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    摘要:

    目的 探讨经皮内镜下清创冲洗术治疗腰椎间隙非特异性感染的临床疗效。方法 回顾性分析2016年9月~2019年9月在我科行经皮内镜下清创冲洗术治疗腰椎间隙非特异性感染的17例患者资料,其中男11例,女6例;年龄51~82岁,平均(66.9±9.4)岁;病变节段:L2/3 3例,L3/4 4例,L4/5 7例,L5/S1 3例。术后根据病理、培养及高通量基因检测结果给予抗感染治疗,监测红细胞沉降率(ESR)及C反应蛋白(CRP)评估感染控制情况,采用疼痛视觉模拟评分(VAS)及改良Oswestry功能障碍指数(ODI)功能评分综合评估临床疗效。结果 所有患者手术均顺利完成,手术时间50~92 min,平均(70.9±12.3)min;术中出血量21~52 ml,平均(35.2±9.8)ml。末次随访时,ESR、CRP、腰部VAS评分、改良ODI均较术前降低(P<0.05)。17例患者获随访12~30个月,平均(20.9±5.8)个月,随访期内MRI等提示感染控制良好。结论 经皮内镜下清创冲洗术治疗腰椎间隙非特异性感染的临床疗效满意,对于合并症多、身体条件差中老年患者尤为适合。

    Abstract:

    Objective To investigate the clinical efficacy of percutaneous endoscopic debridement and drainage for non-specific lumbar intervertebral infection. Methods A retrospective study was conducted to analyze the clinical data of 17 non-specific lumbar intervertebral infection patients admitted to our department from September 2016 to September 2019. There were 11 males and 6 females, aged 51-82 years, with an average age of (66.9±9.4) years. The operative segments were distributed at L2/3 in 3 patients, L3/4 in 4, L4/5 in 7, and L5/S1 in 3 patients. After operation, anti-infective treatment was conducted according to results of pathology, tissue culture and genetic testing. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were monitored to evaluate the condition of infection control. Clinical efficacy was evaluated by visual analogue score (VAS), modified Oswestry dysfunction index (ODI). Results All the operations were successfully completed. The operation time was 50-92 minutes, with a mean time (70.9±12.3) minutes. The intraoperative blood loss was 21-52 ml, with a mean amount of (35.2±9.8) minutes. At the last follow-up, ESR, CRP, VAS and the modified ODI were significantly decreased compared with the preoperative value(P<0.05). 17 patients were followed up for 12-30 months, with a mean time (20.9±5.8) months. During the period, MRI showed that the infection was well controlled without recurrence. Conclusions For non-specific lumbar intervertebral infection, percutaneous endoscopic debridement and drainage was clinically effective, especially for the elderly patients with multiple complications and poor physical conditions.

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  • 收稿日期:2020-12-22
  • 最后修改日期:2020-12-22
  • 录用日期:2021-02-08
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