两种手术方案应用于多发下部胸椎结核患者的效果对比  

Comparison of effects of two surgical methods in the treatment of multiple thoracic spinal tuberculosis

作　　者：韦涵渝[1] 彭小忠[1] 武振国[1] 杨智贤[1] 

机构地区：[1]广西医科大学第四附属医院脊柱外科,柳州545000

出　　处：《广西医科大学学报》2017年第7期1058-1061,共4页Journal of Guangxi Medical University

摘　　要：目的:对比胸膜外病灶清除植骨融合内固定术与肋骨横突病灶清除植骨术两种手术方式治疗多发下部胸椎结核的效果。方法:选取2012年2月至2015年7月广西医科大学第四附属医院收治的80例多发下部胸椎结核患者,将其随机分为对照组和观察组,每组40例。对照组患者给予肋骨横突病灶清除植骨术治疗,观察组患者给予胸膜外病灶清除植骨融合内固定术治疗。比较两组患者的临床疗效、手术情况及并发症发生情况。结果:观察组治疗总有效率为100.00%,明显高于对照组的50.00%(P<0.05)。观察组复发率为2.50%,显著低于对照组的17.50%(P<0.05)。观察组手术时间、胸痛持续时间、植骨融合时间、住院时间均短于对照组(均P<0.05),术中出血量及术后并发症发生率均低于对照组(均P<0.05)。结论:胸膜外病灶清除植骨融合内固定术对多发下部胸椎结核患者的治疗效果优于肋骨横突病灶清除植骨术,能减轻患者手术疼痛,降低并发症发生率和复发率,值得临床推广应用。Objective： To compare the effect of two surgical methods in the treatment of multiple thoracic spinal tuberculosis （MTST）. Methods： 80 MTST patients in our hospital from February 2012 to July 2015 were enrolled and randomly divided into an observation group and a control group, with 40 cases in each group. Patients in the control group received costotransverse radical debridement and bone graft fusion, while those in the observation group received radical debridement and bone graft fusion combined with internal fixation. The clinical effect and the incidence of complications were compared between the two groups. Results： The total response rate in the observation group was higher than that in the control group, while the recurrence rate was significantly lower （P〈0.05）. The duration of chest pain, operation time, bone graft fusion time and hospital days in the observation group were significantly shorter than those in the control group （P〈0.05）. The intraoperative blood-loss volume and the incidence of complications in the observation group were lower than those in the control group （P〈0.05）. Conclusion： Extrapleural radical debridement and bone graft fusion combined with internal fixation was more effective than costotransverse radical debridement for the treatment of MTST. It could relieve pain and reduce the incidence of complications and recurrence rate.

关 键 词：胸椎结核 植骨 病灶清除 

分 类 号：R529.2[医药卫生—内科学]