前路病灶清除联合抗生素治疗兔椎间隙感染

Experimental study on treatment of intervertebral space infection by anterior debridement and antibiotics

目的:观察不同方法治疗兔椎间隙感染的疗效,探讨椎间隙感染的有效治疗方法。方法:采用椎间隙内注射金黄色葡萄球菌,建立椎间隙感染兔模型;将经临床表现、X线、MRI检查、C反应蛋白(CRP)以及红细胞沉降率(ESR)检测证实椎间隙感染兔36只随机均分为3组:前路病灶清除联合抗生素治疗组(SAT组)、先锋霉素Ⅴ治疗组(AT组)、未治疗组(NT组)。治疗后对总体疗效进行比较。结果:NT组体温、ESR及CRP异常,临床症状恶化,病死率高(66.7%),治愈率低(16.7%);AT组体温、ESR及CRP恢复慢或不恢复,临床症状缓解慢,病死率高(50.0%),致残率较高(16.7%),治愈率低(33.3%);SAT组体温、ESR及CRP恢复快,临床症状缓解迅速,治愈率高(91.7%),病死率低(8.3%)。SAT组和AT组治疗效果均高于NT组(P<0.01和P<0.05)。结论:前路手术具有病灶清除彻底,减压充分,临床症状缓解迅速,体温、ESR及CRP恢复快,病理转归好的优点。

Objective：To study the curative effect of different therapies on intervertebral space infection in rabbits.Methods：The model rabbits with intervertebral space infection were stablished by injecting Staphylococcus aureus into the intervertebral space,and the infection was confirmed by radiograph,MRI,ESR,and serum level of CRP.Thirty-six model rabbits were randomly divided into surgical and antibiotic treatment group（SAT）,antibiotic treatment group（AT） and non-treatment group（NT）.The curative effects were compared among the three groups.Results：NT group：the temperature,ESR and level of serum CRP were abnormal and the clinical symptoms deteriorated;the fatality rate was high（66.7%） and cure rate low（16.7%）.AT group：the temperature,ESR and level of serum CRP recovered slowly and the clinical symptoms were uncatabatic;the fatality rate was high（50.0%）,disability rate high（16.7%） and cure rate low（33.3%）.SAT group：the temperature,ESR and level of serum CRP recovered quickly and the clinical symptom improved obviously;the cure rate was high（91.7%） and fatality rate low（8.3%）.The curative efficacy in SAT group and AT group was better than that in NT group（P〈0.01 and P〈0.05）.Conclusions：The anterior debridement can radically eliminate the infection tissues,so the temperature,ESR,level of serum CRP and the clinical symptoms improve quickly after surgery.