Abstract：Objective: To explore the related factors of deep infection of lumbar spinal stenosis after pedicle screw fixation and treatment measures. Methods: 1244 cases of patients treated with pedicle screw fixation due to umbar spinal stenosis in our hospital from April 2011 to April 2016 were selected as the study objects. Single factor and multiple Logistic regression analysis were applied to analyze the related factors of deep infection of lumbar spinal stenosis after pedicle screw fixation. Results: In the study, 11 cases of patients with deep infection from 1244 cases of patients were detected, and 19 strains of pathogens were isolated. Of them, 9 strains were gram positive bacteria (47.37%), 10 strains were gram negative bacteria (52.63%), in which staphylococcus aureus accounted for the highest proportion (44.44%). There were on relations between patients' gender, antibiotic use time and the incidence of deep infection (P > 0.05). Single factor analysis showed factors like age more than 65, operation time more than 100 min, intraoperative blood loss more than 500ml, basic diseases or not, postoperative drainage time less than 2d, and BMI > 30 kg/m2 were closely related to the incidence of deep infection (P< 0.05). Multiple Logistic regression analysis showed independent risk factors were age, operation time, bleeding volume and BMI to induce deep infection (P< 0.05). Conclusion: There are many factors inducing deep infection, and the hospital should do well in perioperative nursing care in order to prevent deep infection.
刘智鹏, 张伟. 腰椎管狭窄症椎弓根内固定术后深部感染的因素分析及处理措施[J]. 河北医学, 2017, 23(10): 1642-1645.
LIU Zhipeng, et al. Analysis on Factors of Deep Infection of Lumbar Spinal Stenosis after |Pedicle Screw Fixation and Treatment Measures. 河北医学, 2017, 23(10): 1642-1645.
[1]俞兴,徐林,毕连涌,等.腰椎后路融合内固定术后早期深部感染的因素分析及治疗[J].中国感染与化疗杂志,2013,27(6):433~437. [2] 黄帅豪,柯雨洪,王义生,等.腰椎后路内固定术后感染的原因分析与治疗体会[J].中国矫形外科杂志,2014,22(21):2002~2005. [3] 王拥军,施杞.腰椎管狭窄症诊断疗效标准[J].中华中医药学会骨伤分会第四届第二次会议论文集,2007,58. [4] 叶应妩,王毓三,申子瑜.全国临床检验操作规程[M].东南大学出版社,2006.87. [5] 张波,杨斌辉,刘丰虎,等.腰椎内固定术后深部低毒性感染的诊治[J].航空航天医学杂志,2011,22(6):707~709. [6] Li X, Lv C, Yan T. Unilateral versus Bilateral Pedicle Screw Fixation for Degenerative Lumbar Diseases: A Meta-Analysis of 10 Randomized Controlled Trials[J].Medical Science Monitor International Medical Journal of Experimental & Clinical Research, 2015, 21(17):782~790. [7] Shi G D, Ouyang Y P, Shi J G, et al. Application of on-line analytical processing in evaluating factors influencing effect of posterior lumbar internal fixation in treatment of lumbar spinal nerve root damage[J].Academic Journal of Second Military Medical University, 2010, 30(6):691~693. [8] 杨林,海涌,周君琳,等.腰椎管狭窄症术后感染及危险因素分析[J].中华医院感染学杂志,2011,21(14):2906~2908. [9] 吴华,刘民,杨雪松,等.腰椎管狭窄症术后手术部位感染危险因素分析[J].首都医药,2012,11(24):12~15. [10] 郝定均,贺宝荣,许正伟,等.腰椎内固定术后深部感染的原因分析及外科处理[J].美中国际创伤杂志,2013,26(1):52~54. [11] 陈鹏,陈刚,朱国兴,等.腰椎术后感染的原因分析与治疗策略[J].临床骨科杂志,2013,16(5):506~509. [12] 王林峰,张静涛,雷涛,等.胸腰椎后路内固定术后伤口早期深部感染的临床分析[J].中国骨与关节外科,2016,9(2):98~102. [13] 黄帅豪,柯雨洪,王义生,等.腰椎后路内固定术后感染的原因分析与治疗体会[J].中国矫形外科杂志,2014,22(21):2002~2005. [14] Corenman D S, Gillard D M, Dornan G J, et al. Recombinant human bone morphogenetic protein-2-augmented transforaminal lumbar interbody fusion for the treatment of chronic low back pain secondary to the homogeneous diagnosis of discogenic pain syndrome: two-year outcomes[J].Spine, 2013, 38(20):1269~1277.
2017, Vol. 23 
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