同种异体骨与自体骨植骨治疗胸腰段结核的研究  

Efficacy of allogenic bone grafting or autogenous bone grafting with posterior debridement instrumentation in the treatment of thoracolumbar tuberculosis

作　　者：王锡阳[1] 罗承科[1] 邓强[2] 葛磊[1] 段春岳[1] 周炳炎[1] 庞晓阳[1] 曾浩[1] 许正权[1] 

机构地区：[1]中南大学湘雅医院脊柱外科,长沙410008 [2]新疆医科大学第一附属医院脊柱外科,乌鲁木齐830054

出　　处：《中国矫形外科杂志》2012年第9期782-785,共4页Orthopedic Journal of China

基　　金：国家自然科学基金项目(编号:81171736)

摘　　要：[目的]探讨同种异体骨和自体骨植骨术在治疗胸腰段结核中的疗效。[方法]回顾分析77例胸腰段结核患者,同种异体骨植骨(A组)40例;自体肋骨植骨(B组)37例。比较两组的手术时间、术中出血量、住院天数和手术前后的ASIA分级、植骨融合率、Cobb角。[结果]随访7～34个月,平均18.6个月。A、B组手术时间、术中出血量、住院天数比较有明显差异(P<0.05)。两组内比较手术前后的ASIA分级、Cobb角有明显差异(P<0.05);两组间比较ASIA分级、Cobb角,植骨融合率无明显差异(P>0.05)。[结论]A、B组术后2.5年复查X线片,按照Zenya Ito标准,植骨融合率没有差异,但A组手术时间短、出血少、住院时间短。[ Objective] To find the efficacy of surgical treatment of thoracolumbar tuberculosis by posterior focus debridement, bone autografts and allogenic bone grafts fusion and internal fixation. [ Methods ] Seventy - seven cases of thoracolumbar tuberculosis were retrospectively studied from January 2006 to February 2011. These cases were divided into two groups： 40 cases in allogenic bone grafts operation group （group A） , and 37 cases in bone autografts operation group （group B） . We evaluated the operation time , blood loss , hospital stay and the perioperative changes of ASIA＇ s grade , bone union rate and Cobb＇ s angle of the two groups respectively, and compare them by the analysis of statistic. [ Results ] All cases were followed up for 7 -34 months （average, 18.6 months） . The difference of the operation time, blood loss and hospital stay between group A and group B was significant （ P 〈 0. 05 ） . In each group, there were significant differences in ASIA, Cobb＇ s angle. The changes of ASIA , Cobb＇ s angle between group A and group B were not significant （P 〉0. 05） . [ Conclusion] According to Zenya Ito, both of the allogenic bone grafts and bone autografts fusion are effective in treating thoracolumbar tuberculosis , however, posterior operation has advantages of shorter operation time , less blood loss and shorter hospital stay.

关 键 词：胸腰椎结核 同种异体骨移植 自体骨移植 骨移植 

分 类 号：R687.3[医药卫生—骨科学]