Perioperative treatment of patients with human munodeficiency virus undergoing spinal surgery / 中国医师进修杂志

ABSTRACT

Objective To observe the effect of perioperative treatment on complications in human immunodeficiency virus positive patients undergoing spinal surgery, and summarize effective perioperative management to make these patients to get better treatment. Methods Forty-eight HIV positive patients (experimental group) and 79 HIV negative patients (control group) undergoing spinal surgery from November 2010 to March 2016 were retrospectively reviewed. The two groups were comparable in age, gender, type of spinal surgery and basic diseases. Nutritional support and the uses of antibiotics and blood transfusion were strengthened in patients of experimental group. Immunomodulatory drugs, the treatment with HAART and occupational protection were also used in patients of experimental group. The patients in control group only received conventional perioperative treatment. Wound healing, opportunistic infection, the failure of internal fixation and death after the operation was observed. The perioperative treatment methods were summarized. Chi square test was used in comparison of the rate and P < 0.05 was considered statistically significant. Results Surgery was successfully completed in all patients in experimental group and control group. Two cases (4.2%) in experimental group and 4 cases(5.1%) in control group showed delayed healing of incisions. All incisions were healed after debridement and no incision infection happened. CD4+T lymphocyte count of 2 cases in the experimental group was in stage 3. Among them, 1 patient underwent emergency surgery and opportunistic infection appeared after the operation. The other patients for elective surgery took operation when CD4+T lymphocyte counts were adjusted to 2 and no complications appeared. The two groups had no internal fixation failure cases and deaths. Conclusions HIV positive patients with spinal diseases are special patients. HIV positive patients with spinal surgery can reduce complications, and achieve good clinical curative effect by reasonable preoperative assessment, optimization of perioperative treatment, proper type of operation and active prevention of opportunistic infections after surgery.