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目的总结持续闭式灌注冲洗引流治疗脊柱内固定术后切口感染患者的护理体会;方法方法回顾性分析2010年1月~2014年12月脊柱内固定术后切口深部感染12例患者的临床资料。临床表现主要为切口脓性分泌物、体温升高和局部疼痛等,血液学及细菌学检查确定有无细菌性感染;结果果随访6个月~4年,平均2.5年。闭式冲洗引流后1周局部症状消失,引流液清亮后拔管2例,2周拔管5例,4周拔管2例;引流后4周,全身症状消失、血常规、CRP、血沉正常后停用抗生素7例,6周后停用抗生素5例。无慢性窦道形成。所有患者在随访期间未见断钉与断棒。结论术前的心理护理、术后的体位护理、疼痛护理,保持闭式灌注冲洗引流通畅及详细的出院指导是促进病人的康复的重要保证。
Objective To summarize the nursing experience of continuous closed perfusion irrigation and drainage in patients with incision infection after spinal internal fixation. Methods The clinical data of 12 patients with deep incision infection after spinal internal fixation from January 2010 to December 2014 were retrospectively analyzed. The main clinical manifestations of purulent incision, body temperature and local pain, hematology and bacteriology to determine the presence of bacterial infection; results were followed up for 6 months to 4 years, an average of 2.5 years. One week after closed flush drainage, local symptoms disappeared, extubation was clear after extubation in 2 cases, extubation in 2 cases in 5 cases and extubation in 4 cases in 2 cases. After 4 weeks of drainage, systemic symptoms disappeared and blood routine, CRP and erythrocyte sedimentation rate were normal After stopping antibiotics in 7 cases, 6 weeks after antibiotics in 5 cases. No chronic sinus formation. All patients during the follow-up no broken nail and broken rod. Conclusion Preoperative psychological care, postoperative care, pain care, to maintain the smooth irrigation and drainage of closed perfusion and detailed discharge guidance is an important guarantee to promote patient rehabilitation.