Abstract：To explore clinical treatment methods of early deep wound infection after lumbar discectomy ,and e-valuate the efficacy .[Methods] Totally 17 patients diagnosed as early deep infection after lumbar discectomy in orthopedic de-partment of our hospital from May 2006 to May 2014 .Among all patients ,13 patients underwent anterior and/or posterior re-moval of infection and catheter lavage ,while 4 patients received non-surgical treatment including antibiotics(>4~6 weeks) ac-cording to bacterial culture and drug sensitivity test and bed rest ,and then wore external fixation brace and took out-of-bed ac-tivity at 1~2 weeks after reaching the curative standard of infection .[Results] VAS score of low back pain in 13 surgical pa-tients at 24~28h after operation was improved from preoperative (8 .7 ± 2 .1) points to (3 .2 ± 1 .3) points ,and the duration of antibiotic usage was (35 ± 2)d .Two patients and other patients undergoing relaxation suture could get well healing of wound 4 weeks and 12~16d after stitch removing .The symptoms of 4 patients with non-surgical therapy were obviously improved af-ter about 4 weeks of treatment ,and the average time of antibiotic usage was (28 ± 1)d ,and VAD score of low back pain was improved from preoperative (7 .9 ± 2 .2) points to (2 .3 ± 1 .4) points .All patients were discharged from the hospital after white blood cell(WBC) ,C-reactive protein(CRP) and/or erythrocyte sedimentation rate (ESR) in all patients returned to the normal reexamined by laboratory ,and MRI signal was the normal or obviously improved .The average hospitalization time was (74 ± 2 .5)d .After follow up for 6~60 months ,all patients had no recurrence of infection .Routine X-ray examination and/or CT showed bony fusion and the recovery of spinal stability .MRI showed the normal or obviously improved signals .All pa-tients got clinical healing .[Conclusion] The effective antibiotic therapy (> 4~6 weeks) and bed rest is the main treatment method for patients diagnosed as early deep wound infection after lumbar discectomy .If the drug therapy is invalid with the persistent rising of temperature and white blood cell and without the decreasing or with the rising of CRP and EST persistently in short term ,or the radiographic image shows the destroyed signal in soft tissue or end plate ,the surgical procedure should be undertaken in time which can alleviate the pain quickly ,shorten the treatment course and get clinical healing .
引用本文:
刘宏哲%刘向阳%黄象望. 腰椎间盘术后早期深部感染的临床处理与疗效评价[J]. 医学临床研究, 2014, 31(8): 1581-1584.
LIU Hong-zhe%LIU Xiang-yang%WANG Xiang-Wang. Clinical Treatment and Efficacy Evaluation of Early Deep Wound Infection after Lumbar Discectomy. JOURNAL OF CLINICAL RESEARCH, 2014, 31(8): 1581-1584.
2014, Vol. 31 
