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感染性盘膜炎的诊断延迟 - - 一个尚未解决的问题
Lisa Grandidge1, Tokunbo Ogunleye2, Michael Thackray2
1Consultant in Spinal Injuries. Princess Royal Spinal Injuries Unit, Northern General Hospital, Sheffield, UK. lisa.grandidge@nhs.net.
诊断脊柱感染的延迟通常发生在入院前,导致严重的神经缺陷和长期残疾. 早期怀疑和炎症标记物的使用对于在脊柱感染病例中及时干预至关重要.
科学领域:
- 神经学 神经学
- 传染性疾病 传染性疾病
- 脊髓损伤 脊髓损伤 脊髓损伤
背景情况:
- 在三分之一的病例中,脊髓感染会导致神经缺陷,往往带有非特异性症状,导致诊断延迟.
- 及时诊断和干预对于管理脊髓感染和预防脊髓损伤等严重后果至关重要.
研究的目的:
- 审查后续脊髓损伤的脊髓感染患者诊断的结果和及时性.
- 确定导致诊断延迟和脊柱感染患者神经系统恶化的因素.
主要方法:
- 一项对40名因脊髓损伤而接受康复治疗的患者的回顾性研究.
- 收集的数据包括患者人口统计,感染源,诊断间隔,神经状态变化和康复结果.
主要成果:
- 患者经历了诊断和MRI的长时间间隔 (0-30天),50%的人先寻求医疗护理.
- 37.5%的患者在入院后神经病情恶化,其中一些人服用抗生素. 17.5%的人持续完全脊髓损伤.
- 大多数 (67.5%) 被解雇为轮椅使用者,这表明长期的重大残疾.
结论:
- 诊断脊髓感染的延迟经常发生在医院前,可能是由于社区怀疑指数较低.
- 尽管接受了抗生素治疗,神经系统的恶化仍然可能发生,这凸显了密切监测的必要性.
- 建议在怀疑脊髓感染时及早使用炎症标志物和研究的低值.
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