CT引导下经皮微创治疗脊柱结核的近期疗效  

Observe on Therapeautic Effectiveness of Percutaneous Minimally Invasive Sugery under CT Guidance in Treatment of Paitents with Spinal Tuberculosis

作　　者：陆晓生[1] 黄湄景 赵劲民[3] 凌尚准[1] 韦文[1] 

机构地区：[1]广西百色市人民医院骨科,广西百色533000 [2]广西百色市民族卫生学校外科学教研室,广西百色533000 [3]广西医科大学第一附属医院创伤手外科,广西南宁530021

出　　处：《实用骨科杂志》2014年第12期1096-1099,共4页Journal of Practical Orthopaedics

基　　金：百色市科学研究与技术开发计划项目(百科计0908027)

摘　　要：目的总结CT引导下经皮微创治疗脊柱结核的近期临床效果。方法 2005年1月至2012年12月对82例脊柱结核患者采用CT引导下行经皮病灶清除,病灶置管,抗结核药物灌注冲洗引流。记录手术时间、术中出血量、住院时间等指标。术后随访时采用Oswestry功能障碍指数评分并参照张西峰等改良的脊柱结核治愈标准进行疗效评估。结果该组患者均顺利手术。复查均未发现结核复发,术后3个月ESR、CRP恢复至正常。所有患者均达到临床治愈,有神经功能损害者均完全恢复,Oswestry功能障碍指数治疗前后比较差异有统计学意义。治疗前后影像学、症状体征改变终末随访时均有明显改善。结论微创治疗疗效好,具有操作简便、安全、创伤小,治疗费用低等优点,对活动期脊柱结核的临床效果好,是理想的微创手术方法。Objective To study the clinical efficacy of percutaneous minimally invasive sugery under CT guidance in treatment of patients with spinal tuberculosis. Methods 82 patients were in the surgical downward CT_guided percutaneous fo_cal cleaning,focus catheter,irrigation and drainage for anti_TB drugs perfusion. Parameters of operative time,volume of blood loss during operation,length of hospital stay after operation were analyzed. Therapeutic effect was assessed by Zhang Xi_feng etc improved spinal tuberculosis cure effect evaluation standards and Oswestry functional disability index. Results Operation was successfully performed in all cases. ESR and CRP returned to normal after 3 months. All patients clinical cured with neurologi_cal impairment recovered. The difference of the Oswestry functional disability index before and after surgery was statistically. The imaging,clinical signs and symptoms before and after treatment were improved obviously. Conclusion Minimally invasive treatment of spinal tuberculosis effect has advantage of operation simple,security,less hurt and lower medical cost,and its clin_ical effect is also good on active tuberculosis of the spine. It is one of ideal minimal invasion operation approaches for spinal tu_berculosis.

关 键 词：脊柱结核 微创手术 CT 引导 灌注冲洗 

分 类 号：R529.2[医药卫生—内科学]