摘要
目的 :评价清创术后置管持续冲洗 ,负压吸引及一期关闭伤口对胸腰椎骨折术后脑脊液漏合并感染的治疗疗效。方法 :回顾 1984年 1月～ 2 0 0 0年 2月 43 4例胸腰椎骨折内固定术后脑脊液漏合并感染 10例 ,(男 8例 ,女 2例 )。结果 :10例均为术后发生 ,脑脊液漏平均出现时间 48h ,感染平均出现时间 4.5d。清创术后除 2例部分内固定取出外 ,其余 8例均予保留。所有病例清创术后置管持续冲洗及负压吸引 ,一期关闭创口 ,平均置管时间 2 2 .5d ,清创术后静脉使用抗菌素 3 1.5d。 1例因颅内及肺部感染死亡 ,9例患者平均随访 3 .5年 ,未见感染复发及假性硬脊膜囊肿形成。结论 :彻底清创术后置管持续冲洗 ,负压吸引及一期关闭伤口 ,对胸腰椎骨折术后脑脊液漏合并感染的治疗是有效的 ,保留置入物 ,不影响对感染的控制。
Objective:To evalute the result of irrigation suction drainage system on the treatment of postoperative wound cerebrospinial fluid leak and infection after thoracolumbar fracture fixation.Methods:A retrospective study was carried out to review the wounded 10 cases of cerebrospinial fluid leak and infection the interal fixation for thoracolumbar fracture from Jan.1984 to Feb 2000 in the 434 cases.Results:10 cases were infected after surgery,the cerebrospinial fluid leak was found 48 hours after surgery on average,the infection was found 4.5 days after surgery.Partial implants were removed in 2 cases.All the cases were treated with debridement and irrigation suction system which was inserted into the wound.The duration of irrgation was 22.5 days on average after surgery.The duration of veneous antibiotic drugs injection was 31.5 days.One case died of infection of intracrainal and lung.At an average time of follow up of 3.5 years,there were no infection recurrence and no presence of the dural pesudocyst.Conclusion:Primary wound closure with irrigation suction drainage after debridement is an effective method in the treatment of wound infection and cerebrospinial fluid leak after thoracolumbar fracture fixation.Maintainance of the interal fixation in place is possible in most cases.
出处
《中国矫形外科杂志》
CAS
CSCD
2002年第9期874-876,共3页
Orthopedic Journal of China
