腰5骶1结核35例临床分析  

Analysis of 35 cases of the tuberculosis in the lumbar-sacral vertebrae

作　　者：傅晨[1] 刘兴炎[1] 王晓峰[1] 甄平[1] 牛海平[1] 

机构地区：[1]兰州军区总医院全军骨科中心,甘肃兰州730050

出　　处：《中国骨伤》2003年第7期401-403,共3页China Journal of Orthopaedics and Traumatology

摘　　要：目的　探讨腰 5骶 1结核的发病特点及治疗手段。方法　本组 35例腰 5骶 1结核病人均给予正规、联用抗痨治疗 4周后手术 ,其中单纯行经前路倒“八”字切口椎体病灶清除术者 2 6例。 5例行经前路倒“八”字切口椎体病灶清除术合并椎管探查、病灶清除术。 4例先行经前路倒“八”字切口椎体病灶清除术 ,半年后Ⅱ期行椎管探查、病灶清除术。结果　经 2～ 5年随访 ,本组结核病均已治愈 ,植骨均融合满意。其中 2 6例腰椎活动度正常 ,无任何不适。其余 9例遗留轻度腰痛 ,腰部活动度略受限 ,该 9例中 4例遗留下肢部分区域皮肤感觉麻木。结论　对于腰 5骶 1结核病例 ,误诊情况较普遍 ,强调抗痨治疗要充分、足量 ,对于该部位手术指征应放宽 ,术中要注意对下腔静脉分叉区域的正确处理。Objective To investigate the clinical features and treatment of the fifth lumbar vertebrae and the first sacral vertebrae tuberculosis(FLFST) Methods 35 cases with FLFST were operated after regular combined with anti-tuberculotic medication.Among them,26 cases were operated for focal cleaning with simple front inverse'八'incision,intravertebral exploration and focal cleaning were conducted in 5 cases besides what had done above.4 patients were operated for focal cleaning with simple front inverse'八'incision at first,6 months later,intravertebral exploration and cleaning were conducted in secondary operation.Results After 2 to 5 years follow-up,all patients were cured and have a satisfactory fusion.26 cases felt no discomfortable and have normal lumbar vertebral activity.9 cases leaved slight back pain and limited lumbar motion.Among the 9 cases,4 leaved partial skin hypoesthesia on lower limbs.Conclusion Patients with FLFST are easy to misdiagnosis.Full antituberculotic medication was emphasis.The operation indication should be compromised to FLFST.It should be pain attention to the furcated regions in lower limbs vena.

关 键 词：骨科手术方法 结核 骨关节 回顾性研究 

分 类 号：R52[医药卫生—内科学]