取环致宫腔化脓性感染引发腰椎间盘炎一例报道并文献复习

宫腔化脓性感染是一种严重的盆腔炎性疾病(PID)，主要表现为发热、腹痛、阴道分泌物增多等症状。椎间盘炎是发生于椎间盘间隙和邻近椎体或软骨板的感染性病变，其症状及体征缺乏特异性，临床上容易诊断延迟直至出现椎体骨质破坏及下肢肌力减弱。本文报道了1例因取环手术引发宫腔化脓性感染进而引发腰椎间盘炎，出现腰痛伴行走障碍的患者，并进行了文献复习，加深了对PID的病原体、感染传播途径、诊断标准、治疗原则及其严重不良后果的认识。对于非特异性椎间隙感染，临床医生除实验室检查及影像学检查之外，还应仔细询问病史并了解病情的演变过程，及时诊断并进行手术治疗。

Lumbar Discitis Due to Intrauterine Purulent Infection Induced by Removing the Intrauterine Contraceptive Ring: a Case Report and Literature Review

Intrauterine purulent infection is a severe pelvic inflammatory disease, which manifests as fever, abdominal pain, and increased vaginal secretions. Discitis is an infectious disease which may both affect the intervertebral disc space and the adjacent vertebrae or cartilage plate. Due to the absence of typical symptoms and signs, the clinical diagnosis of this disease may be delayed until damaged pyramidal bone and decreased lower-limb muscle strength. We reported a case of lumbar discitis caused by intrauterine purulent infection after removing the intrauterine contraceptive ring, presenting with low back pain with walking disorder, then conducted a literature review to deepen the understanding of the pathogens, routes of infection transmission, diagnostic criteria, treatment principles and serious adverse consequences of pelvic inflammatory disease. For nonspecific intervertebral discitis, clinicians should carefully ask for the medical history and the progression of the disease, in addition to laboratory and imaging tests. It is especially important to make a diagnosis and perform the surgery in time.