脓肿清除术联合置管小剂量灌洗处理胸腰椎结核术后复发的临床疗效  

Debridement and local chemotherapy for the recurrence of thoracic and lumbar tuberculosis

作　　者：张宏其[1] 王龙杰[1] 唐明星[1] 尹新华[1] 刘金洋[1] 

机构地区：[1]中南大学湘雅医院脊柱外科,湘雅脊柱外科中心,长沙410008

出　　处：《中国矫形外科杂志》2016年第5期401-405,共5页Orthopedic Journal of China

基　　金：国家自然科学基金资助项目(编号:81271940);湖南省“芙蓉学者”项目

摘　　要：[目的]评价脓肿清除术联合经皮局部置管小剂量异烟肼灌洗治疗胸、腰椎结核经单纯后路一期手术治疗术后复发患者的临床疗效。[方法]回顾分析本科2009年3月~2013年8月收治并获得随访的19例经单纯后路一期病灶清除、植骨融合钉棒内固定术治疗胸腰椎结核的术后复发患者。在全身化疗的同时,行脓肿清除术联合局部置管持续化疗。[结果]随访时间18~48个月,平均36个月,所有患者脓肿清除及局部置管顺利,局部化疗期间患者均未发生交叉感染及窦道形成,没有发生内固定松动断裂等情况。所有患者均达到临床治愈,随访无再次复发。[结论]脓肿清除术联合经皮局部置管化疗创伤小,容易操作,是处理胸腰椎结核经单纯后路一期手术治疗术后复发行之有效的方法。[Objective] To evaluate the effect of debridement and local chemotherapy for the recurrence of thoracic and lumbar tuberculosis after one stage posterior focal cleaning with instrumentation and fusion. [Methods] From 2009 to 2013,19 patients suffering from the recurrence of spinal tuberculosis in our institute were treated and reviewed retrospectively. All the patients had no neurological deficit before surgery. All patients underwent routine chemotherapy and treated with debridement and local chemotherapy. The clinical outcome was measured by spinal tuberculosis cure standard. [Results] During the operation,debridement and tube placement were successful. No cross infection,forming of sinus was noted. All patients were followed up for an average of 36 months（ range,18 months to 48 months） and had evidence of clinical heal. [Conclusion] The treatment of debridement and local chemotherapy is an easy,safe,efficient method for the recurrence of thoracic and lumbar tuberculosis after one stage treatment.

关 键 词：脓肿清除术 局部置管 脊柱结核 复发 小剂量灌洗 

分 类 号：R687.3[医药卫生—骨科学]