手术治疗脊柱结核37例  

Operative treatment of spinal tuberculosis

作　　者：李淑菊[1] 王自立[1] 武永刚[2] 

机构地区：[1]宁夏医学院附属医院骨科,银川750004 [2]武警北京总队第二医院骨科,北京100037

出　　处：《武警医学》2007年第11期835-838,共4页Medical Journal of the Chinese People's Armed Police Force

摘　　要：目的探索脊柱结核的治疗方法，提高脊柱结核的治愈率，减少复发。方法手术治疗脊柱结核37例，采用病椎部分切除、大块髂骨植骨或者放置cage加上前路或者后路内固定。术后超短程化疗，定期复查，检测X线片及血沉。结果随访20-36个月，平均30个月，1例术后出现肺不张，行胸腔积液清理术，1例于术后3周再次出现窦道，重新手术清除病灶。伴有神经症状的均有不同程度的好转，大多数患者血沉恢复正常。术后1年X线片显示植骨融合良好，均回到了工作岗位或者生活自理。结论病椎部分切除、植骨融合、内固定治疗脊柱结核，卧床时间短，可早期活动，复发率低。Objective To search for a good method to treat spinal tuberculosis. Methods Thirty - seven patients with spinal tuberculosis were treated by partial excision of the affected vertebrae,large iliac strut graft and anterior or posterior internal fixation,followed by the ultrashort anti-tuberculosis chemo therapy. AU the patients were checked by X-ray and ESR examination postoperatively.Results All patients were followed - up for 20-36 months with an average of 30 months, one case had a complication of pulmonary atelectasis, another one had a sinus about 3 weeks after operation and was reoperated on. Other patients had no complications. All patients＇ neurological symptoms improved to different extent after trealment The ESR dechned to normal in most patients. The X - ray films taken 1 year after operation showed a good fusion. Conclusions Combination of patial excision of the affected vertebrae, bone graft, and internal fixation is an effective method to treat spinal tuberculosis.

关 键 词：脊柱结核 手术 内固定 植骨融合 超短程化疗 

分 类 号：R681.5[医药卫生—骨科学] R529.2[医药卫生—外科学]