椎管内脓肿的诊断与显微外科治疗

DIAGNOSIS AND MICROSURGICAL TREATMENT OF INTRASPINAL ABSCESS

目的 为提高椎管内脓肿的诊断与显微外科治疗水平 ,回顾性分析经手术病理或细菌培养证实的 6 2例椎管内脓肿临床表现、诊断及治疗结果。方法 6 2例中 ,男 36例 ,女 2 6例。脓肿位于硬脊膜外 37例 ,硬脊膜下 2 3例 ,脊髓内 2例 ,根据病史、临床表现 ,结合MRI与脊髓造影诊断 ,采用手术及早切除病变部位椎板 ,清除脓液及坏死组织。结果 本组随访 5 1例 ,优 2 7例 ,占 5 2 9% ;良 18例 ,占 35 3% ;可 6例 ,占 11 8%。优良率为 88 2 %。结论 对于椎管内脓肿 ,应结合病史 ,早期诊断 ,早期手术清除脓肿 ,可望获得良效。

Objective To evaluate the diagnosis and microsurgical treatment of intraspinal abscesses. Methods The clinical manifestations, diagnosis, and microsurgical treatment of sixty-two patients with intraspinal abscess were retrospectively analyzed. Among them, 36 were male and 26 were female, with an average age of 41 years. Thirty-seven were suffering from extradural abscesses, 23 subdural abscesses and 2 intramedullary abscesses. The diagnosis was made based on the history, clinical manifestations, MRI and myelogram. Prompt decompressive laminectomy and removal of the abscesses were carried out. Results Fifty-one patients were followed up. Of them, 27 completely recovered, accounting for 52.9%; in 18 the recovery was graded as good, accounting for 35.3%; and in 6 the recovery was fair, accounting for 11.8%. Conclusion Early diagnosis and microsurgical intervention of intraspinal abscesses could result in satisfactory recovery.