本文選題：腰椎后路減壓融合內(nèi)固定術(shù)　切入點：術(shù)后感染　出處：《浙江大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：通過回顧性分析腰椎后路減壓融合內(nèi)固定術(shù)后患者的臨床資料,探討腰椎術(shù)后感染的情況及相關(guān)危險因素。為臨床工作中降低腰椎術(shù)后感染的發(fā)生率,提高腰椎后路減壓融合內(nèi)固定術(shù)的治療效果提供借鑒和參考。方法：回顧性分析浙江大學(xué)附屬邵逸夫醫(yī)院2014年6月至2014年12月行腰椎后路減壓融合內(nèi)固定手術(shù)的140例患者的臨床資料。分別記錄術(shù)前1日、術(shù)后1、3、5、7日檢測白細胞(WBC)、中性粒細胞百分比(N%)及C反應(yīng)蛋白(CRP)。根據(jù)以下幾項標(biāo)準(zhǔn),判斷患者術(shù)后發(fā)生感染：(1)術(shù)后3-5天的CRP值大于第2天CRP值的80%；(2)術(shù)后第5天CRP下降值小于1/2最高峰值；(3)術(shù)后5天后CRP連續(xù)升高2次,并且后一次比前一次升高超過15 mg/L。另外若患者術(shù)后出現(xiàn)發(fā)熱體溫持續(xù)超過38℃、手術(shù)部位局部有紅腫熱痛表現(xiàn),結(jié)合手術(shù)部位B超,CRP、 WBC及N%升高,切口分泌物或深部穿刺的細菌培養(yǎng)結(jié)果陽性,則判斷為早期脊柱術(shù)后深部感染。結(jié)果：60歲以上的患者感染率為8.82%,與60歲以下的患者感染率5.56%相比無顯著性差異(P0.05)。男性患者感染率為7.69%,與女性患者感染率6.67%無顯著性差異(P0.05)。BMI24kg/m2的患者感染率為12.73%,與BMI24kg/m2的患者感染率3.53%相比有顯著性差異(P0.05)�；加刑悄虿〉幕颊咝g(shù)后感染率為18.18%,與未患糖尿病的患者感染率3.74%相比有顯著性差異(P0.05)。手術(shù)時間大于180分鐘的患者術(shù)后感染率為9.43%,與手術(shù)時間小于180分鐘的患者感染率5.75%相比無顯著性差異(P0.05)。結(jié)論：1.糖尿病、肥胖是術(shù)后感染的危險因素,而年齡、性別、手術(shù)時間等因素暫無統(tǒng)計學(xué)差異。2.CRP在術(shù)后第3天達到最高峰,WBC在術(shù)后第1天最高,術(shù)后1周回復(fù)正常水平范圍。
[Abstract]:Objective: to analyze retrospectively the clinical data of patients after lumbar posterior decompression fusion and internal fixation, and to explore the situation of postoperative infection of lumbar vertebrae and related risk factors in order to reduce the incidence of postoperative infection in clinical work. To improve the treatment effect of lumbar posterior decompression fusion internal fixation. Methods: retrospective analysis of posterior lumbar decompression fusion and internal fixation from June 2014 to December 2014 in run run Shaw Hospital, Zhejiang University. Clinical data of 140 patients were recorded on 1st. In 7th, WBC, neutrophil percentage and C-reactive protein (CRP) were measured. The CRP value of 3 to 5 days after operation was higher than that of CRP on the second day. The CRP drop value on the 5th day after operation was less than 1/2, the peak value was less than 3) the CRP increased twice 5 days after operation. In addition, if the patient's fever and body temperature continued to exceed 38 鈩，

本文編號：1598655