一期后路病灶清除植骨融合内固定矫形治疗成人腰骶段结核的临床疗效观察  

Efficacy of Single-stage Posterior Debridement and Bone Graft Fusion with Internal Fixation in Adult Lumbosacral Tuberculosis

作　　者：赖福崇 王琦[1,2] 蔡恒 王垒 翟文通 杜君 魏云强 李骥征 LAI Fu-chong;WANG Qi;CAI Heng(Yunan University of Chinese Medicine,Kunming,650500,China)

机构地区：[1]云南中医学院,昆明650500 [2]云南省中医医院,昆明650021

出　　处：《黑龙江医学》2019年第6期580-581,584,共3页Heilongjiang Medical Journal

基　　金：国家自然科学基金地区基金(81460736);云南省教育厅科学研究基金项目(2018Y074)

摘　　要：目的探讨一期后路病灶清除植骨融合内固定术治疗腰骶段结核的疗效。方法选取36例云南省中医医院接收的腰骶段结核患者,就诊时间为2014年5月—2016年5月期间,均行一期后路病灶清除植骨融合内固定术,随访至少24个月,观察疗效。结果手术后,患者胸背痛、结核中毒症状等消失,伤口愈合可。末次随访时,患者腰骶角、血沉均显著改善,与术前比较差异有统计学意义(P<0.05),患者均无结核复发现象。末次随访时,患者Frankel分级35例为E级,1例患者由术前的B级恢复至D级;至末次随访时未发生手术及药物相关并发症,术后6~8个月,36例患者获得BridwellⅠ级植骨融合34例,2例BridwellⅡ级植骨融合。结论成人腰骶段结核采取一期后路病灶清除植骨融合内固定矫形治疗,安全可靠,疗效确切,值得推广。Objective To discuss the efficacy of single-stage posterior debridement and bone graft fusion with internal fixation in lumbosacral tuberculosis. Methods 36 lumbosacral tuberculosis adults underwent the single-stage posterior debridement and bone graft fusion with internal fixation from May,2014 to May,2016 in the hospital were selected. After 24 months of follow-up visit,the clinical efficacy was evaluated. Results The chest and back pain,and tubercular toxicity were disappeared;the wound healing was favorable. During the final visit,the lumbosacral angle and blood sedimentation rate improved remarkably(P<0.05);None recurrent tuberculosis cases were found. According to Frankel’s grading,35 cases were appeared as stage E,1 case at stage B was recovered to stage D;none complications were discovered. After 6~8 months of surgery,34 cases had BridwellⅠ of graft fusion,and 2 cases at Bridwell Ⅱ of graft fusion. Conclusion The single-stage posterior debridement and bone graft fusion with internal fixation can improve the clini? cal safety,with efficient reliability. So it is worth promotion.

关 键 词：腰骶段结核 内固定矫形 后路 植骨融合 

分 类 号：R323.43[医药卫生—人体解剖和组织胚胎学]