CT血管成像在下腰椎结核手术中的应用  

Application of CT angiography in the operation of lower lumbar tuberculosis

作　　者：蒲清平 郭涛[2] PU Qingping;GUO Tao(Guizhou University of Traditional Chinese Medicine,Guiyang 550002,China)

机构地区：[1]贵州中医药大学,贵阳550002 [2]贵州省人民医院骨科,贵阳550002

出　　处：《实用医学杂志》2019年第14期2308-2310,共3页The Journal of Practical Medicine

基　　金：贵州省人民医院博士基金项目(编号:GZSYBS[2017]12号)

摘　　要：目的探究CT血管成像(CTA)在下腰椎结核手术中的应用价值。方法收集贵州省人民医院骨科2016年12月至2018年6月间下腰椎结核患者60例(男女各30例),术前均行腹部大血管CTA以明确下腰椎前血管的走行情况及与椎体之间的关系,测量椎前血管的相关解剖学参数,进行相关术前评估后行手术治疗。总结术中、术后血管损伤并发症的发生情况。结果CTA清晰显示了椎前血管的走行与结核脓肿、椎体的毗邻关系。术中精准找到了髂血管位置并进行保护,手术中无一例发生大血管损伤,仅有3例发生髂内静脉分支血管损伤。结论下腰椎前血管走行受结核脓肿影响较大,术前行腹部大血管CTA明确血管走行与结核病灶及周围组织的关系,制定可靠的手术方案,可以有效避免血管并发症的发生。Objective To explore the value of CT angiography(CTA)in the operation of lower lumbar tuberculosis.Methods A total of 60 patients(30 males and 30 females)with lower lumbar tuberculosis were collected from December 2016 to June 2018 in the Department of Orthopedics,Guizhou Provincial People′s Hospital.Before the operation,CTA of abdominal great vessels was performed for preoperative evaluation to determine anterior vessel shape of the lower lumbar spine and the relationship with vertebral body and to measure the anatomical parameters of anterior vertebral vessels,followed by surgical treatment.Subsequently,the complications of vascular injury were summarized during and after operation.Results CTA showed the shape of anterior vertebral vessels as well as the adjacent relationship with tuberculosis abscess and vertebral body clearly.Meanwhile,the position of iliac vessels was accurately located and protected intraoperatively.No major vascular injury was occurred during the operation,and only three patients showed injury of branches of internal iliac vein.Conclusions The anterior vessel shape of lower lumbar spine is greatly affected by tuberculosis abscess.Preoperative CTA of abdominal great vessels may facilitate the identification of the relationship of blood vessel shape with tuberculosis focus and surrounding tissues,and formulate reliable surgical plan,which can effectively avoid the occurrence of vascular complications.

关 键 词：下腰椎结核 血管解剖 CT血管成像 血管损伤 

分 类 号：R687.3[医药卫生—骨科学] R816.8[医药卫生—外科学]