脊柱内固定术后早期切口深部感染的诊治探讨

Diagnosis and treatment of postoperative early wound deep infection in spinal internal fixation

目的探讨脊柱内固定术后早期切口深部感染的有效治疗方法。方法对2013年3月至2018年1月来我院治疗的10例脊柱内固定术后早期切口深部感染患者,采用抗生素治疗、清创、置管冲洗与负压封闭引流治疗。其中男4例,女6例,年龄20?66岁,平均(49.6±12.8)岁,颈椎肿瘤1例、腰椎管狭窄症3例、腰椎间盘突出症2例、腰椎滑脱症3例、胸腰椎骨折1例。结果10例患者均获治愈,清创次数为1?5次。早期所有病例在清创术后2?8周愈合,内固定装置均完整保留。对患者进行随访,时间6?24个月,未见复发病例。结论脊柱内固定术后早期切口深部感染,通过应用敏感抗生素治疗、清创、置管冲洗或负压封闭引流,所有感染患者均治愈,同时内固定物得以保留。

Objective To explore the effective treatment of postoperative early wound deep infection in spinal internal fixation. Methods From March 2013 to January 2018, 10 patients with wound deep infection after spinal internal fixation in our hospital were treated with antibiotic, debridement, closed suction irrigation and vacuum sealing drainage (VSD). There were 4 males and 6 females, with an average age of (49.6±12.8) years (aged from 20 to 66 years), including 1 cervical spine tumor, 3 lumbar spinal stenosis, 2 lumbar disc herniation, 3 lumbar spondylolisthesis and 1 thoracolumbar fracture. Results All of the 10 patients were cured with 1~5 debridations. All the early cases were healed for 2 to 8 weeks after debridement, and the internal fixation devices were completely retained. Patients were followed up for 6 to 24 months. No recurrence was found. Conclusion Postoperative early wound deep infection in spinal internal fixation can be cured and the internal fixator can be retained by using sensitive antibiotics, debridement, closed suction irrigation and vacuum sealing drainage (VSD).