脊柱侧凸患者术后感染预后影响分析

Influence of postoperative infections on prognosis of scoliosis patients

目的探讨特发性脊柱侧凸患者术后并发感染对其预后的影响,为改善患者预后提供理论依据。方法回顾性分析2011-2013年收治的100例特发性脊柱侧凸患者临床资料,根据术后是否感染分为感染组与非感染组,感染组5例,非感染组95例,比较两组患者的手术情况、影像学资料和脊柱侧凸研究会问卷(SRS-22)评分,数据均采用SPSS软件进行统计分析。结果 100例特发性脊柱侧凸患者中出现术后感染5例,感染率为5.0%,1例患者于术后第12天出现感染,4例患者于术后6~31个月内出现迟发性感染;感染患者主要临床表现为渗液、局部肿胀、背部疼痛、发热;感染组患者在术前脊柱侧凸Cobb角度、侧凸柔韧性、术后即刻脊柱侧凸Cobb角度、术后即刻矫正率分别是(58.7±10.2)°、(51.8±16.1)%、(16.4±9.7)°、(69.7±9.8)%,与非感染组比较差异均无统计学意义;感染组随访后脊柱侧凸Cobb角度是(45.3±14.6)°,大于非感染组,差异有统计学意义(P<0.05);感染组患者在手术时间、融合椎体数、总输血量、总出血量分别是(262.4±53.2)min、(10.3±1.4)个、(734.8±276.5)ml、(1033.2±408.9)ml,与非感染组比较差异均无统计学意义。结论特发性脊柱侧凸术后感染造成原有矫正率丢失,导致患者降低了治疗满意度,可采取应用抗菌药物、内固定物移除术、清创等措施减少术后感染的发生。

OBJECTIVE To explore the influence of postoperative infections on prognosis of the idiopathic scoliosis patients so as to provide theoretical basis for improvement of prognosis of the patients. METHODS The clinical data of 100 cases of idiopathic scoliosis who were treated in the hospital from 2011 to 2013 were retrospectively analyzed, then the subiects were divided into the infection group with 5 cases and the non-infection group with 95 cases according to the status of postoperative infections, the operation status, imaging data, and Sco[iosis Research Society （SRS-22） score were observed and compared between the two groups, and the statistical analysis was performed with the use of SPSS software. RESULTS Of the 100 cases of idiopathic seoliosis, the postoperative infections occurred in 5 cases with the infection rate of 5.0~, including 1 case of infections that occurred 12 days after surgery and 4 cases of infections that occurred within 6-31 months after surgery. The main clinical manifestations of the patients with infections included the exudates, local swelling, back pain, and fever. The preoperative scoliosis Cobb angle, scoliosis flexibility, postoperative instant scoliosis Cobb angle, and postoperative instant correction rate of the patients in the infection group were （58.7 ! 10.2） ~, （51.8-[-16.1） ~, （16.4-~9.7） ~, and （69.7!9.8） %, respectively, as compared with the patients in the non-infection group, the differences were not statistically significant; the scoliosis Cobb angle of the infection group was （45.3 ~ 14.6）~ after follow-up, higher than that of the non-in^ection group, the difference was statistically significant（P^0.05）. The operation duration o5 the infection group was （262.4~53.2）rain, fused vertebrae number （10.3~1.4）, total volume of blood transfusion （734.8~276.5）ml, total amount of bleeding （1033.2~408.9）ml, as compared withthose of the postoperative non-infection infections in the the patients＂ satisfaction with group, the differences were not statistically significant. CONCLUSION The patients with idiopathic scoliosis may result in the loss of correction rate and reduce treatment; the use of antibiotics, internal fixation removal, and debridement can reduce the incidence of postoperative infections