经肋横突病灶清除治疗胸椎结核的临床疗效分析  

Clinical analysis of surgical management to thoracic vertebra tuberculosis by costotransversectomy

作　　者：杨显声[1] 闫景龙[1] 迟志永[1] 昌广平[1] 

机构地区：[1]哈尔滨医科大学附属第一医院骨科,黑龙江150001

出　　处：《脊柱外科杂志》2008年第5期281-283,共3页Journal of Spinal Surgery

摘　　要：目的探讨胸椎结核外科治疗的手术策略及围手术期处理等问题。方法回顾性分析2005年1月-2006年6月期间接受病灶清除、植骨融合手术治疗并获得随访的20例胸椎结核患者的临床资料。其中16例胸椎结核患者接受经肋横突入路一期病灶清除、植骨融合、内固定术,4例未行内固定手术。观察术后和随访期间患者结核中毒症状和神经功能的改善情况,植骨融合情况及治愈率。结果术后结核中毒症状明显缓解,神经功能明显改善,6个月时85%植骨愈合,治愈率为90%。结论胸椎结核手术治疗中内固定的应用是安全、有效的,术式制定和内固定的选择应根据病变节段、范围和经济情况等综合判断。Objective To analyze the clinical effect of surgical management and perioperative management of thoracic spinal tuberculosis. Methods Twenty patients with spinal tuberculosis that underwent the operation of debridement and fusion between January 2005 to June 2006 were documented respectively. Sixteen patients were treated with internal fixation and 4 patients without fixation. To observe the tubercular toxic symptom, neurological improvement, the fusion rate and recovery rate of post-operation and follow-up period. Results The toxic symptom of tuberculosis alleviated greatly and neurological function improved postoperatively. At 6 postoperative months, 85% patients got bone graft fusion and recovery rate was 90%. Conclu, sion The application of internal fixation in the operative treatment of spinal tuberculosis was safe and effective. The design of operative strategy and the selection of internal fixation should be based on the segments and range of spine involved, economy condition and so on.

关 键 词：胸椎 结核 脊柱 脊椎融合术 内固定器 

分 类 号：R529.23[医药卫生—内科学]