脊柱结核的诊断及围手术期的处理  

The Diagnosis and Perioperative Management of Spinal Tuberculosis

作　　者：黄绍贤[1] 梁显球 余斌[1] 陈志军[1] 杨耿华[1] 

机构地区：[1]肇庆市第二人民医院骨科,广东肇庆526060

出　　处：《中国医疗前沿（学术版）》2008年第11期6-7,共2页China Healthcare Innovation

摘　　要：目的探讨脊柱结核的临床诊断，避免误诊，进一步探讨围手术期的处理。方法系统回顾我院从1997年至2008年收治的脊柱结核病例41例，其中2例误诊为腰椎间盘突出症，2例误诊为椎管狭窄症，1例误诊为强直性脊柱炎，后修正诊断。41例均行病灶清除，一期植骨融合术，围手术期处理包括规则化疗、支具保护及有效临测。结果36个病例获得随访，随诊时间1．5-3．5年，平均2．1年，病灶无局部复发，后凸畸形矫正18．6度，植骨融合时间平均4．5个月。结论对于脊柱结核的诊断，临床上需结合多方面的因素进行综合分析，才能避免误诊。正确的围手术期处理对手术治疗的临床效果具有非常关键的作用。Objective To discuss the clinical diagnosis of spinal tuberculosis, in order to avoid misdiagnosis, further exploring the perieperative management.Methods Systematic Review of 41 cases with spinal tuberculosis treated by our hospital from 1997 to 2008, of which 2 cases misdiagnosed as lumbar disc herniation, 2 cases misdiagnosed as spinal stenosis, 1 case misdiagnosed as ankylosing spondylitis, the misdiagnoses were amended then. Debridement and single-stage autograft bone fusion were performed on 41 cases, with perioperative management, including conventional chemotherapy, support protection and effective clinical monitoring.Results 36 cases received follow-up from 1.5 to 3.5 years, the average period was 2.1 years, without local recurrence of the lesions, kyphosis deformity corrected by 18.6 degrees, the average fusion time was 4.5 months.Conclution For the diagnosis of spinal tuberculosis, only combining various factors into a comprehensive analysis clinically, can avoid misdiagnosis. Correct perioperative management plays a vital role in the clinical effects of surgical treatment.

关 键 词：脊柱结核 误诊 植骨融合术 围手术期处理 

分 类 号：R529.2[医药卫生—内科学] R473.6[医药卫生—临床医学]