胸腰椎结核不同手术入路临床治疗效果及相关指标分析  

Clinical Effects and Analysis of Indicators for Thoracic and Lumbar Tuberculosis by Different Operation Approach

作　　者：吴广森[1] 才晓军[1] 田斌[1] 崔继东[1] 李宏伟[1] 靳青[1] 

机构地区：[1]解放军第309医院骨科,北京100091

出　　处：《医学研究杂志》2012年第5期52-55,共4页Journal of Medical Research

摘　　要：目的观察单纯前路、单纯后路和前后联合入路治疗胸腰椎结核的临床效果及相关指标分析。方法回顾2001年6月～2011年6月间笔者所在科室收治的107例胸腰椎结核患者,分别采用单纯前路、单纯后路或前后联合入路进行手术结核病灶清除和脊柱稳定性重建,随访3～36个月,观察其临床治疗效果并对手术相关指标进行统计学分析。结果在手术治愈率、复发率、以及神经功能改善方面,3种术式比较无统计学差别;在畸形矫正度方面:单纯前路<单纯后路和前后联合入路,而后两者比较无统计学差别;在术后矫形角度丢失方面,前后联合入路<单纯后路<单纯前路;而在手术时间、术中出血量、术后并发症和医疗总费用方面,单纯后路<单纯前路<前后联合入路。结论 3种不同手术入路治疗胸腰椎结核均能达到良好的临床效果,但前入路和前后联合入路手术操作复杂、术后并发症多、医疗费用高。从短期的临床研究结果看,后入路手术优势更明显、更具可选择性,而远期效果尚需进一步的观察。Objective To observe the clinical effect and analysis of indicators by only anterior, only posterior or combined anterior and posterior approach for the treatment of thoracic and lumbar tuberculosis. Methods From June 2001 to June 2011, 107 patients with thoracic and lumbar tuberculosis were treated in our department with a debridement and reconstruction of spinal stability, respectively by only anterior, only posterior or combined anterior and posterior approach. We observed its clinical therapeutic effect and analyzed those indicators relating operations by following up 3 -36 months. Results In the operation cure rate, recurrence rate, and improved neurologica function, there was no statistical difference between three kinds of operation. In the correction of deformity,there was only anterior 〈 only posterior or combined anterior and posterior approach, and no statistically significant difference was found between the latter two. In the postoperative orthopedic angle loss. There was combined anterior and posterior approach 〈 only posterior 〈 only anterior. While in operation time, intraoperative blood loss, postoperative complications and total medical costs. There was only posterior 〈 only anterior 〈 combined anterior and posterior approach. Conclusion Three different operation approach for the treatment of thoracic and lumbar tuberculosis can achieve good clinical results, but there is the more complex surgical operation, the more postoperative complications, and thehigher medical costs by only anterior or combined anterior and posterior approach. From the short - term clinical findings, the operation type by only posterior approach is the more advantages and more selective, but the long - term effects need further observation.

关 键 词：脊柱结核 胸腰椎 手术入路 病灶清除 

分 类 号：R45[医药卫生—治疗学]