经后路全脊椎切除治疗结核治愈型胸腰椎角状后凸畸形效果分析  

Analysis of effect of posterior approach vertebral column resection in treatment of tuberculous thoracolumbar angular kyphosis

作　　者：张永强[1] 李东伦 Zhang Yongqiang;Li Donglun(The People＇s Hospital of Yibin County,Yibin,Sichuan 64460)

机构地区：[1]宜宾县人民医院,四川宜宾644600

出　　处：《基层医学论坛》2018年第29期4086-4088,共3页The Medical Forum

摘　　要：目的探讨经后路全脊椎切除治疗结核治愈型胸腰椎角状后凸畸形的临床疗效。方法收集2013年1月—2014年3月期间入我院接受经后路全脊椎切除术治疗的15例结核治愈型胸腰椎角状后凸畸形患者作为研究对象,回顾性分析其临床资料,总结治疗方法及手术疗效。结果 15例患者均成功完成矫形术,手术时间320 min^460 min;出血量1 500~2 400 mL;术中仅1例出现胸膜破裂,经处理未发生血气胸;15例患者均Ⅰ期愈合,且恢复过程中未发生螺钉松动、神经功能损伤加重等不良现象。患者后凸Cobb角治疗前60°~101°,治疗后改善为10°~27°,畸形矫正率平均达(68.8±6.6)%,效果显著(P<0.05)。术前有神经功能损伤者均有所改善。结论经后路全脊椎切除治疗结核治愈型胸腰椎角状后凸畸形疗效确切,可改善患者形象美观度,也使局部生理功能得以恢复。Objective To explore the clinical effects of posterior approach vertebral column resection in treatment of tuberculous thoracolumbar angular kyphosi. Methods 15 cases of patients with tuberculous cured thoracolumbar angular kyphosis and who treated with posterior approach vertebral column resection in our hospital from January,2013 to March,2014 were collected as the research objects. Then,the clinical data were analyzed retrospectively,and the treatment method and the clinical effect were summarized. Results 15 cases of patients were successfully completed the orthopedics surgical,and the operation time was 320 min^460 min,and the amount of bleeding was 1500~2400 mL;1 cases had pleural rupture treated without the occurrence of hemopneumothorax dystrophy;15 cases were healed in one stage,and there was no bad screw loosening and aggravation of nerve function during the recovery process. Only 1 cases had pleural rupture treated without the occurrence of hemopneumothorax dystrophy;15 cases were healed in one stage,and there was no bad screw loosening and aggravation of nerve function during the recovery process. The patients with kyphosis Cobb angle were 60° ~101° before treatment,and the improvement was 10° ~27° after treatment. The average correction rate of malformation was（68.8±6.6）%,and the improvement was significant（P〈0.05）.The patients who had nerve function injury before treatment improved. Conclusion The clinical effects of posterior approach vertebral column resection in treatment of tuberculous thoracolumbar angular kyphosi are accurate,the orthopedics can improve the image beauty and restore the local physiological function.

关 键 词：结核治愈型胸腰椎角状后凸畸形 后路 全脊椎切除 临床疗效 

分 类 号：R687.3[医药卫生—骨科学]