同轴双管持续性冲洗引流治疗腰椎间盘术后椎间隙感染的临床研究

Clinical study of lumbar intervertebral disc gap infection after treatment with a coaxial double tube ongoing irrigation drainage method

目的探讨用同轴双管持续性冲洗引流方法治疗腰椎间盘术后椎间隙感染的临床疗效,以提高治愈率。方法 2009年10月-2012年10月医院收治的25例腰椎间盘术后椎间隙感染患者随机分成两组,其中治疗组13例采用同轴双管持续性冲洗引流术,对照组12例采用非手术治疗,使用石膏腰围固定,观察两组的治疗效果,病原菌种类、实验室常规检查结果变化,数据采用SPSS 12.0软件处理。结果治疗组和对照组感染的病原菌主要有金黄色葡萄球菌、大肠埃希菌、表皮葡萄球菌、阴沟肠杆菌,两组患者在感染病原菌差异无统计学意义;两组患者与术前比较,血沉增快、C-反应蛋白升高、体温升高、白细胞计数和分类升高差异均有统计学意义(P<0.05);治疗组有8例显效,4例好转,而对照组有5例显效,3例好转,治疗组总有效率为92.31%,与对照组66.67%相比,差异有统计学意义(P<0.05)。结论同轴双管持续性冲洗引流可有效清除病灶,缓解减压腰椎间盘压力,提高腰椎间盘术后患者间隙感染的治疗效果。

OBJECTIVE To investigate the clinical efficacy of lumbar intervertebral disc space infection after treat- ment with a coaxial double tube ongoing irrigation drainage method so as to improve the cure rate. METHODS A total of 25 cases of lumbar intervertebral disc gap infection patients after lumbar intervertebral disc space surgery admitted to the hospital from Oct 2009 to Oct 2012 were randomly divided into two groups, including the treat- ment group of 13 cases of persistent coaxial dual irrigation drainage surgery and the control group of 12 patients using non-surgical treatment, making use of gypsum for waist fixation. The treatment effect, pathogen types, changes in routine laboratory test results were observed in both groups. The data were processed with sPSS12.0 software. RESULTS The treatment group and the control group were mainly infected by the pathogens such as Staphylococcus aureus , Escherichia coli , Staphylococcus epidermidis , and Enterobacter cloacae, with no signifi- cant difference （P〉0.05） in terms of the types and number of pathogenic bacteria in the two groups of patients. As for the two patient groups comparison with that before surgery, the erythrocyte sedimentation rate （ESR） was faster , c-reactive protein （CRP） was elevated, body temperature was higher, and white blood cell count and clas- sification was elevated, which were significant （P〈0.05） ; in the treatment group, there were eight cases with marked effect, 4 cases with improvement; while in the control group, there were 5 cases with marked effect, and 3 eases with improvement. The total effective rate of treatment was 92.31%. Compared with 66.67% of the con- trol group, the difference was significance （P〈0.05）. CONCLUSION The coaxial dual irrigation persistent drain- age can effectively remove the lesion, relieve pressure lumbar disc pressure, and improve the treatment effect of gap infection among patients with lumbar intervertebral disc surgery.