抗生素骨水泥间隔治疗脊柱内固定手术深部感染的疗效分析
Antibiotic bone cement spacer in the treatment of deep wound infection after spinal internal fixation
蔡晓敏 1余专一 2李浩 1聂小羊 1顾佳龙 1袁亚南 1周江军 1谢肇 3赵敏2
作者信息
- 1. 330000 南昌,解放军联勤保障部队第九○八医院骨科
- 2. 335000 鹰潭,鹰潭市人民医院骨科
- 3. 400000 重庆,陆军军医大学附属西南医院骨科
- 折叠
摘要
目的 观察抗生素骨水泥间隔治疗脊柱内固定术后感染的临床疗效.方法 选取2015年3月至2023年12月解放军联勤保障部队第九○八医院骨科收治的25例脊柱内固定术后深部切口感染患者.分为骨水泥组(彻底清创后植入抗生素骨水泥者,n=10)、非骨水泥组(未使用抗生素骨水泥,n=15).比较两组患者清创次数、伤口愈合情况、36项简明健康状况调查(SF-36)评分,及内固定保留情况.结果 骨水泥组均行一次性清创+抗生素骨水泥间隔旷置,感染均被根治,其中2例取出内固定,其余8例保留;9例伤口均于清创2周内愈合,1例因骨水泥间隔外露无法愈合,二次手术取出后愈合.非骨水泥组有8例行一次性清创后治愈,其余7例需多次清创;其中5例取出内固定,其余10例保留.骨水泥组末次随访躯体健康评分及心理健康评分明显高于非骨水泥组(P＜0.05).结论 抗生素骨水泥间隔是治疗脊柱内固定术后深部切口感染的有效方法,在减少死腔的同时,也实现了局部靶向给药的目的.
Abstract
Objective This study was aimed to observe the clinical efficacy of antibiotic bone cement in the treatment of in-fection after spinal internal fixation.Methods A retrospective analysis was made of the 25 patients with infection after spinal inter-nal fixation who had been treated at our hospital from March 2015 to December 2023.Antibiotic bone cement was implanted after radi-caldebridement in 10 of them(cement group),but was not in 15 of them(no-cement group).The times of debridement,wound healing,36 concise health status survey(SF-36)scores and internal fixation retention were compared.Results The infection was cured in the cement group with one-time debridement.Internal fixation was removed in 2 cases and retained in the other 8 cases.The wounds of 9 cases healed within 2 weeks after debridement,and 1 case could not heal because of exposure of bone cement spacer and healed after the operation of removing bone cement.In the no-cement group,8 cases were cured after one-time debridement,and the other 7 cas-es needed multiple debridement.Internal fixation was removed in 5 cases and retained in the other 10 cases.In the last follow-up Physi-cal Component Score(PCS)and the Mental Component Score(MCS)of the cement group were higher than that of the no-cement group(P＜0.05).Conclusion Antibiotic bone cement exclu-sion is an effective method for the treatment of wound infection af-ter spinal internal fixation.It not only reduces the dead space,but also achieves the purpose of local targeted drug delivery.
关键词
脊柱内固定/抗生素骨水泥/手术部位感染/聚甲基丙烯酸甲酯Key words
spinal internal fixation/antibiotic bone cement/surgical site infection/polymethyl methacrylate引用本文复制引用
出版年
2024
NETL
NSTL
万方数据