Diagnostic And Therapeutic Value Of Diagnostic Puncture For Early Fever After Internal Fixation Of Spinal Column

Objective: The significance of diagnostic puncture in the diagnosis and treatment of early fever after spinal internal fixation and the guidance of early diagnosis and treatment of deep incision infection.Methods: A retrospective analysis was made on the medical records of 42 patients with fever after spinal internal fixation from January 2015 to January 2018.42 patients were examined by blood routine,procalcitonin,erythrocyte sedimentation rate,C-reactive protein and other laboratory examinations.MRI indicated the presence of deep wound effusion.Diagnostic puncture and bacterial culture plus drug sensitivity were given.Results: The mean WBC,CRP,ESR and PCT in the infected group were 14.16±0.20,193.26±7.34,84.47±2.49 and 5.88±0.39,respectively.The mean WBC,CRP,ESR and PCT in non-infectious patients were7.40±0.31,46.86± 3.06,46.09(+2.41)and 0.06±0.01,respectively.It was higher than that in non-infected group(P < 0.05).Among them,33 cases had absorbed heat,and their body temperature returned to normal after drainage of wound effusion by diagnostic puncture.In 9 patients with early deep wound infection,bacterial culture and drug sensitivity of wound puncture fluid indicated the presence of bacterial infection,and sensitive antibiotics were replaced immediately.After 3 days of systemic treatment with sensitive antibiotics,early thorough debridement combined with systemic sensitive antibiotics was used to treat the symptoms of poor temperature control or worsening infection such as swelling and pain in the wound.At 3-month follow-up,all patients achieved bone fusion without signs of lumbar instability and pseudoarthrosis.Conclusion: Diagnostic puncture has diagnostic and therapeutic significance for early fever after spinal internal fixation.It can not only treat fever caused by absorption of necrotic substances and wound effusion,but also diagnose fever caused by wound infection at an early stage,so as to intervene treatment at an early stage.The abnormal elevation of procalcitonin,WBC,neutrophil and the changes of CRP and ESR were significantly different from those of patients with heat absorption(P < 0.05),which was of diagnostic significance for early wound infection.