手术治疗腰椎间隙感染疗效分析

The surgical effect of debridement and irrigation for lumbar intervetebral space infection

目的探讨病灶清除＋置管冲洗治疗腰椎间隙感染的疗效。方法对9例腰椎间隙感染患者行病灶清除＋置管冲洗。术后冲洗至全身局部症状消失、引流液清亮、引流液3次培养无细菌生长。同时静脉用两联抗生素至拔管后1～2周，再改口服抗生素巩固治疗4～6周。绝对卧床3—6个月。结果平均冲洗时间25．7d。随访6～24个月，7例痊愈，2例复发。复发的2例均有炎症向上位椎间隙扩散，其中1例用同样的方法治愈，另1例经长时间使用抗生素及消炎镇痛治疗基本治愈。结论病灶清除＋置管冲洗手术治疗腰椎间隙感染，疗效确切，可缩短疗程。

Objective To study the therapeutic effect of debridement and closed irrigation for intervertebral space infection. Methods 9 patients of lumbar intervertebral space infection were treated. Debridement were performed. Two tubes were inserted into intervertebral space. After opertion, saline with Gentamycin was used to irrigate intervertebral space continously. When clinical symptoms disappeared,irrigation solution was clear and three times cultures showed negative, to stopped the irrigation. At the time of irrigation, two kinds of antibiotics were used through venous injection. Drip injection was continued for 1 ～ 2 weeks after operation. After that, oral antibiotics were used for 4 ～ 6 weeks. The patients were kept in bed for 3 - 6 months. Results The irrigation were done for average 25.7 days. All of patients were followed up for 6 - 24 months. 7 patients were cured. Infection recurred in 2 patients, and the infection diffused to upper intervertebral space. One of them was cured after the same way treatment, the other was cured after using antibiotics and anti-inflammation drugs for a long time. Conclusions The effect of debridement an＇d persistent irrigation is effective for lumbar intervertebral space infection,which can shorten the course of treatment.