本文選題：脊柱炎 + 細(xì)菌感染��； 參考：《北京大學(xué)學(xué)報(bào)(醫(yī)學(xué)版)》2017年02期

【摘要】：目的:分析培養(yǎng)陰性化膿性脊柱炎的臨床特征,探討培養(yǎng)陰性是否影響患者治療及預(yù)后。方法:回顧性分析北京大學(xué)第一醫(yī)院骨科2010年1月至2015年12月期間收治的化膿性脊柱炎患者共27例,根據(jù)病原菌培養(yǎng)結(jié)果將患者分為培養(yǎng)陰性組和培養(yǎng)陽(yáng)性組,對(duì)比不同培養(yǎng)結(jié)果患者臨床特征以及預(yù)后情況。結(jié)果:培養(yǎng)陰性率為48.1%(13/27),培養(yǎng)陽(yáng)性組病原菌以葡萄球菌為主。統(tǒng)計(jì)結(jié)果顯示,培養(yǎng)陰性組的紅細(xì)胞沉降率(erythrocyte sedimentation rate,ESR)(P=0.056)、C-反應(yīng)蛋白(C-reactive protein,CRP)低于培養(yǎng)陽(yáng)性組,椎旁膿腫的發(fā)生率(P=0.046)高于培養(yǎng)陽(yáng)性組。兩組患者年齡、性別、入院疼痛視覺(jué)模擬評(píng)分(visual analogue scale score,VAS)、危險(xiǎn)因素、臨床癥狀、體征和脊柱受累情況差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。培養(yǎng)陰性組患者行開放清創(chuàng)手術(shù)率與培養(yǎng)陽(yáng)性組患者相比差異無(wú)統(tǒng)計(jì)學(xué)意義(P=0.414)。經(jīng)治療后,兩組患者住院時(shí)間、ESR、CRP下降速度、疼痛緩解情況以及感染復(fù)發(fā)率差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。兩組患者ESR下降速度均慢于CRP。結(jié)論:化膿性脊柱炎培養(yǎng)陰性患者的ESR、CRP低于培養(yǎng)陽(yáng)性患者,椎旁膿腫發(fā)生率高于培養(yǎng)陽(yáng)性患者。藥物治療后,兩組患者行開放清創(chuàng)手術(shù)率、抗生素應(yīng)用時(shí)間、復(fù)發(fā)率相比差異無(wú)統(tǒng)計(jì)學(xué)意義,培養(yǎng)陰性并不影響化膿性脊柱炎患者的治療及預(yù)后,但培養(yǎng)陰性患者的抗生素抗菌譜廣,長(zhǎng)時(shí)間應(yīng)用需警惕耐藥菌及二重感染。
[Abstract]:Objective: to analyze the clinical features of culture-negative suppurative spondylitis and to explore whether culture-negative affects the treatment and prognosis of patients. Methods: a total of 27 patients with suppurative spondylitis treated in the Orthopaedic Department of Peking University first Hospital from January 2010 to December 2015 were retrospectively analyzed. According to the results of pathogen culture, the patients were divided into culture negative group and culture positive group. The clinical characteristics and prognosis of patients with different culture results were compared. Results: the negative rate of culture was 48.1% and 13 / 27%. Staphylococcus was the main pathogen in positive culture group. The results showed that the erythrocyte sedimentation rate of the negative culture group was lower than that of the positive culture group, and the incidence of paravertebral abscess was higher than that of the positive culture group. There was no significant difference in age, sex, visual analogue scale scoreVASA, risk factors, clinical symptoms, signs and spinal involvement between the two groups (P 0.05). The rate of open debridement in culture negative group was not significantly different from that in positive culture group. After treatment, there was no significant difference between the two groups in the time of hospitalization and the decreasing speed of ESR-CRP, the relief of pain and the recurrence rate of infection (P 0.05). The decrease rate of ESR in both groups was slower than that in CRP. Conclusion: the level of ESR-CRP in the culture-negative patients with suppurative spondylitis is lower than that in the culture-positive patients, and the incidence of paravertebral abscess is higher than that in the culture-positive patients. After drug treatment, there was no significant difference in open debridement rate, antibiotic use time and recurrence rate between the two groups. Negative culture did not affect the treatment and prognosis of patients with suppurative spondylitis. However, the antibiotic spectrum of culture-negative patients is wide, and it is necessary to be on guard against drug resistant bacteria and double infection for a long time.
【作者單位】： 北京大學(xué)第一醫(yī)院骨科;
【分類號(hào)】：R681.5

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 費(fèi)仕相,吳岳嵩,陳瑞和;化膿性脊柱炎18例報(bào)告[J];中國(guó)航天工業(yè)醫(yī)藥;1999年04期

2 曾麗雯;黎海東;譚艷;史曉陽(yáng);戎曉靜;何靈芝;;原發(fā)性化膿性脊柱炎患者的護(hù)理體會(huì)[J];護(hù)士進(jìn)修雜志;2011年13期

3 孫輝;誤診化膿性脊柱炎6例分析[J];臨床誤診誤治;1994年05期

4 房桂云，，郝明珠，王月訓(xùn)，李敬山;化膿性脊柱炎影像學(xué)診斷（附23例分析）[J];CT理論與應(yīng)用研究;1995年01期

5 郭斌;徐強(qiáng);郭德熾;;化膿性脊柱炎手術(shù)治療體會(huì)(附6例報(bào)告)[J];江西醫(yī)藥;1987年03期

6 崔金聲;馬青;韓光明;;化膿性脊柱炎誤診病例分析(附11例報(bào)告)[J];青海醫(yī)藥雜志;1992年05期

7 付敏;高梁斌;;多節(jié)段頸椎化膿性脊柱炎1例[J];實(shí)用醫(yī)學(xué)雜志;2008年19期

8 吳忌;王慶甫;;腰椎化膿性脊柱炎1例[J];中醫(yī)正骨;2012年12期

9 王金堂,尹益民,耿介,張小衛(wèi);化膿性脊柱炎——附10例臨床報(bào)告[J];陜西醫(yī)學(xué)雜志;1992年10期

10 唐桂長(zhǎng),郝明珠,王月訓(xùn);化膿性脊柱炎影像學(xué)診斷(附23例分析)[J];CT理論與應(yīng)用研究;1993年04期

相關(guān)會(huì)議論文 前2條

1 徐侃;;化膿性脊柱炎的外科治療[A];2012年浙江省創(chuàng)傷骨科新進(jìn)展學(xué)習(xí)班論文集[C];2012年

2 楊琳;陳秀君;夏一蘭;魯琛;;13例化膿性脊柱炎的護(hù)理[A];2006年浙江省骨科學(xué)術(shù)會(huì)議暨浙江省脊柱脊髓學(xué)術(shù)會(huì)議論文匯編[C];2006年

相關(guān)碩士學(xué)位論文 前5條

1 趙曉丹;脊柱結(jié)核與化膿性脊柱炎CT鑒別診斷[D];青島大學(xué);2015年

2 鄭煥東;化膿性脊柱炎的診斷及治療方式的選擇[D];浙江大學(xué);2009年

3 鄭華偉;化膿性脊柱炎的診斷及治療[D];浙江大學(xué);2015年

4 劉華;化膿性脊柱炎的手術(shù)治療[D];浙江大學(xué);2007年

5 劉濤;MRI及病理學(xué)在鑒別早期脊柱炎癥中的應(yīng)用及價(jià)值[D];山東大學(xué);2014年

本文編號(hào)：1834574