The Tuo Method In TCM Surgery Combined With Debridement And Continuous Irrigation And Drainage In The Treatment Of Pyogenic Lumbar Infection

Objective: To explore the clinical efficacy of Tuo Method in TCM Surgery combined with debridement and continuous irrigation and drainage in the treatment of pyogenic lumbar infection,so as to provide a new idea for the combination of traditional Chinese and western medicine in the treatment of pyogenic lumbar infection.Methods: The data of 11 inpatients with pyogenic lumbar infection treated by Tuo Method in TCM Surgery combined with debridement and continuous irrigation and drainage from July 2018 to June 2020 in the affiliated Hospital of Shandong University of TCM were analyzed retrospectively.Statistics of perioperative data and follow-up of all patients: the changes of VAS score,lumbar JOA score and infection related indexes were compared,and lumbar X-ray,CT and MRI were used for imaging evaluation.SPSS 21 software was used for statistical analysis.Results: All patients were followed up for 9 to 24 months,with an average of(15.55 ± 4.23)months.The operation time was 80～330min,with an average of(158.18 ± 68.38)min;the amount of bleeding was 40～600ml,with an average of(235.45 ± 175.86)ml;the days of washing were 5～25d,with an average of(14.91 ± 5.74)d;the days of drainage were 5～26d,with an average of(16.73 ± 6.03)d;the days of intravenous antibiotics were 16～56d,with an average of(27.64 ± 12.35)d;the days of postoperative hospitalization were 17 ～ 64 d,with an average of(31.64±14.07)d.Clinical etiological diagnosis was Staphylococcus aureus in 2 cases,methicillin-resistant Staphylococcus epidermidis,Staphylococcus epidermidis,Staphylococcus hominis subsp.Hominis,Acinetobacter Jones,Pseudomonas Mendoza,Enterobacter aerogenes and Escherichia coli in 1 case,and bacterial culture negative in 2 cases.During the follow-up,the VAS scores of all patients gradually decreased with the passage of time,and the difference was statistically significant(P < 0.05);the lumbar JOA scores gradually increased with the passage of time,and the difference was statistically significant(P < 0.05).At the last follow-up,the infection related indexes of all patients were reduced to the normal range.In terms of imaging,6 patients with interbody fusion have achieved bone fusion,8 patients with internal fixation after operation,except for 1 case of secondary debridement and removal of internal fixation,the internal fixation of the remaining 7 patients were stable without loosening;the cure rate of infection in all patients was72.73% after one-stage treatment and 100% after two-stage treatment,and no infection was re published in all patients until the last follow-up Now.Conclusion:(1)It is an effective method to treat pyogenic lumbar infection by continuous irrigation and drainage after the infection focus is completely removed.(2)For the surgical site infection after lumbar internal fixation,surgical debridement and continuous irrigation and drainage should be performed as soon as possible after early diagnosis.(3)TCM treatment of pyogenic lumbar infection can refer to the theory of traditional Chinese medicine surgery-LIUZHU,take the Tuo Method in TCM Surgery as internal treatment rule,cooperate with TCM Decoction intervention,combined with western medicine conventional treatment,can achieve satisfactory clinical effect.