前路病灶清除联合抗生素治疗兔椎间隙感染

    Experimental study on treatment of intervertebral space infection by anterior debridement and antibiotics

    • 摘要: 目的: 观察不同方法治疗兔椎间隙感染的疗效,探讨椎间隙感染的有效治疗方法。方法: 采用椎间隙内注射金黄色葡萄球菌,建立椎间隙感染兔模型;将经临床表现、X线、MRI检查、C反应蛋白(CRP)以及红细胞沉降率(ESR)检测证实椎间隙感染兔36只随机均分为3组:前路病灶清除联合抗生素治疗组(SAT组)、先锋霉素Ⅴ治疗组(AT组)、未治疗组(NT组)。治疗后对总体疗效进行比较。结果: NT组体温、ESR及CRP异常,临床症状恶化,病死率高(66.7%),治愈率低(16.7%);AT组体温、ESR及CRP恢复慢或不恢复,临床症状缓解慢,病死率高(50.0%),致残率较高(16.7%),治愈率低(33.3%);SAT组体温、ESR及CRP恢复快,临床症状缓解迅速,治愈率高(91.7%),病死率低(8.3%)。SAT组和AT组治疗效果均高于NT组(P <0.01和P < 0.05)。结论: 前路手术具有病灶清除彻底,减压充分,临床症状缓解迅速,体温、ESR及CRP恢复快,病理转归好的优点。

       

      Abstract: Objective: To study the curative effect of different therapies on intervertebral space infection in rabbits. Methods: The model rabbits with intervertebral space infection were stablished by injecting Staphylococcus aureus into the intervertebral space,and the infection was confirmed by radiograph,MRI,ESR,and serum level of CRP. Thirty-six model rabbits were randomly divided into surgical and antibiotic treatment group (SAT), antibiotic treatment group (AT) and non-treatment group (NT). The curative effects were compared among the three groups. Results: NT group:the temperature,ESR and level of serum CRP were abnormal and the clinical symptoms deteriorated; the fatality rate was high(66.7%) and cure rate low(16.7%). AT group:the temperature,ESR and level of serum CRP recovered slowly and the clinical symptoms were uncatabatic; the fatality rate was high (50.0%), disability rate high (16.7%) and cure rate low(33.3%). SAT group:the temperature,ESR and level of serum CRP recovered quickly and the clinical symptom improved obviously; the cure rate was high(91.7%) and fatality rate low(8.3%). The curative efficacy in SAT group and AT group was better than that in NT group(P < 0.01 and P < 0.05). Conclusions: The anterior debridement can radically eliminate the infection tissues,so the temperature,ESR,level of serum CRP and the clinical symptoms improve quickly after surgery.

       

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