病灶部位局部灌洗链霉素预防脊柱结核术后感染：回顾性分析。
Topical streptomycin irrigation of lesions to prevent postoperative site infections in spinal tuberculosis: a retrospective analysis.
机构信息
Gansu University of Chinese Medicine, Lanzhou, China.
First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China.
出版信息
J Orthop Surg Res. 2023 Aug 10;18(1):592. doi: 10.1186/s13018-023-04059-y.
PURPOSE
In spinal tuberculosis surgery, topical administration of drugs to the lesion is a preventive treatment measure. The aim is to achieve better bacterial inhibition and to prevent complications. As one of the most common complications after spinal tuberculosis surgery, many factors can lead to surgical site infection (SSI). No definitive reports of local streptomycin irrigation of the lesion and SSI of spinal tuberculosis have been seen. This study analyzed data related to surgical site infections (SSI) after the treatment of spinal tuberculosis using this regimen.
METHODS
In this study, 31 were in the observation group (streptomycin flush) and 34 in the control group (no streptomycin flush). All patients received the same standard of perioperative care procedures. General information, operative time, intraoperative bleeding, ESR and CRP at one week postoperatively, time on antibiotics, total drainage, days in hospital, incision infection rate and secondary debridement rate were compared between the two groups.
RESULTS
Patients in both groups completed the surgery successfully. The ESR and CRP levels in the observation group were lower than those in the control group one week after surgery (p < 0.05); the duration of postoperative antibiotics and hospital stay were lower than those in the control group (p < 0.05); the incidence of SSI in the two groups was 5.88% and 6.45% respectively, with no significant difference (p > 0.05).
CONCLUSION
The use of topical streptomycin irrigation of the lesion during surgical procedures for spinal tuberculosis had no significant effect on the incidence of SSI, however, it helped to control the level of infection in the postoperative period and reduced the length of time patients had to use postoperative antibiotics and the number of days they stayed in hospital. Future prospective randomised controlled trials in more centres and larger samples are recommended.
目的
在脊柱结核手术中，局部应用药物治疗病变是一种预防治疗措施。其目的是实现更好的细菌抑制，并预防并发症。作为脊柱结核手术后最常见的并发症之一，许多因素可导致手术部位感染（SSI）。尚未有局部链霉素冲洗病变和脊柱结核 SSI 的明确报道。本研究分析了使用该方案治疗脊柱结核后与手术部位感染（SSI）相关的数据。
方法
本研究中，31 例为观察组（链霉素冲洗），34 例为对照组（无链霉素冲洗）。所有患者均接受相同的围手术期护理程序。比较两组患者的一般信息、手术时间、术中出血量、术后一周 ESR 和 CRP、抗生素使用时间、总引流量、住院天数、切口感染率和二次清创率。
结果
两组患者均顺利完成手术。观察组术后一周 ESR 和 CRP 水平低于对照组（p<0.05）；术后抗生素使用时间和住院时间短于对照组（p<0.05）；两组 SSI 发生率分别为 5.88%和 6.45%，差异无统计学意义（p>0.05）。
结论
在脊柱结核手术中使用局部链霉素冲洗病变对 SSI 的发生率没有显著影响，但有助于控制术后感染水平，减少患者术后使用抗生素的时间和住院天数。建议未来在更多中心和更大样本中进行前瞻性随机对照试验。
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