三角形外固定踝关节融合术治疗踝关节结核43例临床分析  

Clinical analysis of triangular external fixation arthrodesis for treatment of ankle joint tuberculosis in 43 cases

作　　者：兰汀隆[1] 董伟杰[1] 范俊[1] 唐恺[1] 李元[1] 严广璇 秦世炳[1] 

机构地区：[1]首都医科大学附属北京胸科医院骨科北京骨关节结核诊疗中心,101149

出　　处：《中国防痨杂志》2016年第4期282-286,共5页Chinese Journal of Antituberculosis

摘　　要：目的探讨三角形外固定踝关节融合术治疗踝关节结核的临床疗效。方法回顾性分析2009年1月至2014年12月我科采用三角形外固定踝关节融合术治疗晚期踝关节结核患者43例的临床资料、术前处理、手术方法、术后并发症、术后处理、骨性融合率及手术要点。结果手术时间85～180min，平均（105．7±31．1）min，术中出血量20～90m1，平均（56．2±13．3）ml。术后并发症发生率11．6％（5／43）。术后随访9～36个月，平均（15．6±4．7）个月。41例获得骨性融合，2例为纤维性粘连，融合率为95．3％；融合时间为3～9个月，平均（4．3±2．9）个月。所有患者结核病灶均治愈，其站立、行走时患踝的疼痛采用视觉模拟评分法（visualanaloguescale，VAS）评价，41例骨性融合患者VAS评分O～3分，2例纤维性粘连患者VAS评分为2～4分。结论在合理的抗结核药物支持下，三角形外固定踝关节融合术是治疗踝关节结核的一种安全、可靠的手术方法。Objective To evaluate the efficacy of triangular external fixation arthrodesis in the treatment of ankle joint tuberculosis （TB）. Methods The clinical data, preoperative treatment, surgical methods, postopera- tive complications, postoperative treatment, bony fusion rate and the key point of the operationwere analyze retro- spectively in 43 cases with ankle joint tuberculosis admitted and treated with triangular external fixation arthrodesis in our hospital during January 2009 to December 2014. Results The average operation time was （105.7±31.1） min （range from 85 to 180 min） and the average amount of bleeding during operation was （56.2± 13.3） ml （range from 20 to 90 ml）. Postoperative complication rate was 11.6%. The average followed-up time was （15.6±4. 7） months （range from 9 to 36 months）. 41 cases achieved bony fusion and the other 2 cases got fibrous adhesion. The bony fusion rate was 95.3%. The fusion average time was （4.3±2.9） months （range from 3 to 9 months）. All patients were cured. The pain from operative ankle joint was evaluated using visual analogue score （VAS） when standing up and walking. VAS was 0 3 scores in 41 patients with bony fusion and 2--4 scores in 2 patients with fibrous adhe- sion. Conclusion With support of reasonable anti-TB drugs therapy, the triangular external fixation arthrodesis is a safe and reliable method for the treatment of ankle joint TB.

关 键 词：结核 骨关节 关节融合术 外固定器 

分 类 号：R687.4[医药卫生—骨科学]