摘要
目的:探讨老年脊柱术后急性感染诊断及治疗。方法:回顾性分析了50例经手术病理证实的老年脊柱术后急性感染患者的临床及MRI资料,对椎体、椎间盘改变、椎旁脓肿及椎管内硬膜外脓肿的MRI表现进行分析。将高负压封闭引流术(high vacuum sealing drainage,VSD)应用于本组患者的临床治疗之中,对该方法的临床疗效进行评价。结果:1经病理诊断结果为化脓性脊椎炎、化脓性椎间盘炎以及继发硬模外脓肿分别为15例、14例及21例;经MRI诊断,化脓性脊椎炎、化脓性椎间盘炎以及继发硬模外脓肿分别为14例、12例及19例,与病理诊断符合率为90.00%。2经VSD术治疗后,优、良、中、差例数分别为22例、25例、3例、0例,治疗优良率为94.00%;非感染组(n=120)患者治疗后,优、良、中、差例数分别为56例、58例、6例及0例,治疗优良率为95.00%。3VSD术治疗前掌倾角与尺偏角分别为(4.23±0.72)°与(10.22±1.34)°,治疗后掌倾角与尺偏角分别为(5.78±1.32)°与(13.13±2.11)°,治疗前后掌倾角与尺偏角相比,差异均具有统计学意义(P<0.05)。结论:MRI对老年脊柱术后急性感染具有较高的诊断价值;VSD术治疗老年脊柱术后急性感染的效果较佳,值得在临床上加以推广并应用。
Objective:To investigate the elderly postoperative spinal diagnosis and treatment of acute infection. Methods:The clinical and MRI data of 50 cases of elderly patients with acute infection were retrospectively analyzed by pathologically confirming spinal sur-gery. The vertebrae,intervertebral discs change,paraspinal abscess and spinal epidural abscess MRI findings were analyzed. Then the high-vacuum sealing drainage ( VSD) was applied to the clinical treatment of this group of patients,and the clinical efficacy was evalua-ted. Results:① Results of pathological diagnosis:pyogenic spondylitis,pyogenic discitis and abscess secondary to hard outside were 15 cases,14 cases and 21 cases;diagnosed by MRI,pyogenic spondylitis,purulent disc inflammation and abscess secondary to hard outside were 14 cases,12 cases and 19 cases,and pathological diagnosis was 90. 00%.② The degree of VSD surgery treatment of excellent, good,bad,fair,poor were 22 cases,25 cases,3 cases,0 cases,and the treatment rate is 94. 00%;non-infection group (n = 120) of pa-tients of excellent,good,fair,poor were 56 cases,58 cases,six cases and 0 cases,and the treatment rate is 95. 00%.③ VSD treatment forefoot angle and ulnar deviation were (4. 23 ± 0. 72)° and (10. 22 ± 1. 34)° after treatment. Palmar angle and ulnar deviation were (5. 78 ± 1. 32)° and (13. 13 ± 2. 11 )°. Comparing palmar angle before and after treatment with ulnar deviation,the differences were statistically significant ( P〈0. 05 ) . Conclusion:MRI spine in elderly patients with acute infection has a high diagnostic value;VSD treatment of elderly patients with acute spinal infection was better,and it is worth to be promoted in clinical application.
出处
《川北医学院学报》
CAS
2014年第4期382-385,共4页
Journal of North Sichuan Medical College