文章简介

出版社:Eur J Orthop Surg Traumatol

作   者:Hideki Nagashima• Yoshiro Nanjo• Atsushi Tanida• Toshiyuki Dokai• Koji Yamane• Ryota Teshima

编   号:10.1007/s00590-012-1081-1

年   份:2013    点击量:1204

文章摘要 全文翻译

Abstract

Advances in chemotherapy for various malignancies have contributed to the increased life expectancy of patients. If such a patient has a concurrent infection, his/her oncologist would hesitate to perform prompt chemotherapy owing to the risk of inducing sepsis. Therefore, the treatment of infection would have priority over initiating chemotherapy for the malignancy. We present a 69-year-old female with malignant lymphoma requiring prompt chemotherapy who also demonstrated spinal infection with Mycobacterium tuberculosis and a 66-year-old male with esophageal cancer who also demonstrated spinal infection with Staphylococcus aureus. Anterior debridement and interbody fusion were performed for both patients. One patient died of malignant lymphoma 4 years after surgery, and the other is still alive and has remained disease-free 4 years after surgery. Saving the life of a patient with malignancy would be difficult without prompt chemotherapy. Conservative treatment for spinal infection requires prolonged antibiotic treatment, and there is no guarantee that the spinal infection would be controlled only with antibiotics. Therefore, early surgical intervention would be an alternative option under such a condition.
摘要

用以治疗恶性肿瘤的化疗领域已有许多进展,这些新进展大大延长了患者的寿命。如果患者同时并发感染性疾病,肿瘤科医生会犹豫是否要立即实施化疗,因为会有诱发脓毒症的风险。因此,对于这样的恶性肿瘤患者,治疗感染总是优先于化疗。文中讲述了一例69岁女性患者,患恶性淋巴瘤,需要立即化疗,同时并发结核杆菌引起的脊柱感染,以及一例66岁男性患者,患食管癌,同时并发金黄色葡萄球菌引起的脊柱感染。两名患者均行前路病灶清除术和植骨融合术。术后4年,其中一名患者死于恶性淋巴瘤,另一名患者仍健在。如果不及时化疗,要想挽救恶性肿瘤患者的生命是有难度的。脊柱感染的保守治疗需进行长期抗生素治疗,但仅以抗生素治疗并不能保证脊柱感染得以控制。因此,在这种情况下早期手术干预也许是另一种可选方式。