脊柱术后早期手术部位感染患者持续闭合灌洗引流治疗的疗效评价

Evaluation of the Efficacy of Continuous Closed Lavage and Drainage in the Treatment of Early Surgical Site Infection after Spinal Surgery

目的探究脊柱术后早期手术部位感染患者持续闭合灌洗引流治疗的疗效。方法抽取该院脊柱术后早期手术部位感染患者66例,诊治时间为2018年7月-2019年6月,全部采用持续闭合灌洗引流治疗,观察患者伤口病原菌情况、主要致病菌的耐药率以及术后临床指标情况。结果共检出病原菌60株,革兰氏阳性菌有48株,占80.00%,革兰氏阴性菌12株,占20.00%;主要致病菌是金黄色葡萄球菌、表皮葡萄球菌,青霉素的耐药率分别为80.00%、90.00%;红霉素的的耐药率分别为100.00%、90.00%;万古霉素、利奈唑胺的耐药率均为0.00%,其余抗菌药物均有小程度耐药性;患者平均灌洗时间为(10.7±1.9)d,抗菌药物灌洗时间为(12.3±2.4)d。患者手术前白细胞(WBC)、血沉(ESR)、C-反应蛋白(CRP)水平分别为(18.9±1.2)×10^9/L、(43.6±6.8)mm/h、(19.5±1.7)mg/L;手术后WBC、ESR、CRP水平分别为(7.9±0.9)×10^9/L、(13.6±1.4)mm/h、(7.5±1.1)mg/L。手术后WBC、ESR、CPR均显著低于手术前,差异有统计学意义(t=42.127、24.823、34.044,P<0.05)。结论脊柱术后早期手术部位感染患者采取持续闭合灌洗引流疗法的治疗效果好,并发症发生情况少,患者恢复得更快更好,值得临床大力推广应用。

Objective To investigate the efficacy of continuous closed lavage drainage in patients with early surgical site infection after spinal surgery. Methods Sixty-six patients with early surgical site infection after spinal surgery were enrolled in the hospital. The diagnosis and treatment time was from July 2018 to June 2019. All patients were treated with continuous closed lavage drainage to observe the pathogens of wounds and the resistance of major pathogens. Rate and postoperative clinical indicators. Results A total of 60 pathogenic bacteria were detected, 48 strains of Gram-positive bacteria, accounting for 80.00%, and 12 strains of Gram-negative bacteria, accounting for 20.00%. The main pathogens were Staphylococcus aureus, Staphylococcus epidermidis and penicillin resistance. The drug rates were80.00% and 90.00% respectively;the resistance rates of erythromycin were 100.00% and 90.00%, respectively;the resistance rates of vancomycin and linezolid were 0.00%, and the other antibiotics were resistant to a small degree. The medicinal properties;the average lavage time of patients was(10.7±1.9) d, and the lavage time of antibacterial drugs was(12.3±2.4) d. The preoperative white blood cell(WBC), erythrocyte sedimentation rate(ESR), and C-reactive protein(CRP) levels were(18.9±1.2)×10^9/L,(43.6±6.8) mm/h, and(19.5±1.7) mg/L, respectively. The WBC, ESR, and CRP levels after surgery were(7.9±0.9)×10^9/L,(13.6±1.4) mm/h,(7.5±1.1) mg/L. WBC, ESR and CPR were significantly lower than those before surgery, and the difference was statistically significant(t=42.127, 24.823, 34.044, P<0.05). Conclusion Patients with early surgical site infection after spinal surgery have a good therapeutic effect with continuous closed lavage drainage therapy, less complications, and faster and better recovery. It is worthy of clinical application.