不同入路一期病灶清除植骨固定治疗脊柱结核的临床比较  

Clinical comparison of different approaches of stage Ⅰ debridement,bone grafting and internal fixation in treatment of spinal tuberculosis

作　　者：黄晓魏[1] 颜志坚[1] 麦伟[1] 张维成[1] 方文焕[1] 

机构地区：[1]广东省湛江中心人民医院骨科,广东湛江524037

出　　处：《中国当代医药》2013年第29期20-21,共2页China Modern Medicine

摘　　要：目的 探讨不同入路一期病灶清除植骨前后入路内固定术治疗脊柱结核的效果观察.方法 回顾性分析本院2010年5月～2012年5月收治的脊柱结核患者43例,所有患者均采用一期病灶清除、椎间植骨及内固定进行手术治疗,根据术中入路方法不同分为两组,前入路（n=22例）和后入路（n=21例）,两组患者术后按照手术时间、术中出血量、骨融合时间和术后1年Cobb角的平均值和红细胞沉降率及术后功能评分进行比较.结果 前入路组手术时间短于后入路组,术中出血量少于后入路组,差异有统计学意义（P＜0.05）；骨融合时间、术后1年Cobb角和红细胞沉降率差异无统计学意义（P＞0.05）.前入路组功能评分优良率为81.82％,后入路组优良率为71.43％,两组优良率比较,差异无统计学意义（x2=0.1981,P＞0.05）.结论 在正规抗结核治疗的前提下,采用一期病灶清除植骨前后入路内固定术治疗脊柱结核均具有可靠的疗效.Objective To investigate the efficacy of different approaches of stage I debridement,bone grafting and in- ternal fixation in the treatment of spinal tuberculosis.Methods Clinical information of 43 patients with spinal tubercu- losis admitted to our hospital from May 2010 to May 2012 was analyzed retrospectively.The patients were divided into two groups：the anterior approach group （n=22） and the posterior approach group （n=21）.The operative time,intraopera- rive blood loss,bone fusion time,mean time of postoperative 1-year Cobb angle,erythrocyte sedimentation rates and postoperative functional scores of the two groups were compared.Results The operative time,intraoperative blood loss was lower than that of the posterior approach group （P〈0.05）,bone fusion time,mean time of postoperative 1-year Cobb angle,erythroeyte sedimentation rate and postoperative functional score of the two groups bad no significant difference （P〉0.05）.Conclusion On the premise of standard anti-tuberculosis treatment,both anterior and posterior approaches of stage I debridement,bone grafting and internal fixation are reliable and effective in the treatment of spinal tuberculosis,

关 键 词：脊柱结核 一期病灶清除植骨内固定术 前后入路 疗效 

分 类 号：R68[医药卫生—骨科学]