胸腰椎结核不同手术入路临床疗效的对比  

Clinical effect comparison of different surgical approach for thoracolumbar spinal tuberculosis

作　　者：朱灏 史可测 刘波[1] 张华溢 Hao ZHU;Kece SHI;Bo LIU;Huayi ZHANG(Department of Spinal Surgery,Leshan People’s Hospita,Leshan Sichuan 614000,China)

机构地区：[1]乐山市人民医院脊柱外科

出　　处：《国际感染病学（电子版）》2019年第4期75-76,共2页Infection International(Electronic Edition)

摘　　要：目的比较不同手术入路进行胸腰椎结核一期病灶清除、植骨融合、内固定的临床效果.方法通过对2004年1月-2019年1月137例胸腰椎结核患者根据病情需要采取前路、后路、前后路联合入路病灶清除、植骨融合、内固定术治疗,患者年龄11岁-74岁,平均37岁,前入路59例,后入路40例,前后联合入路38例.对三种不同手术入路手术时间、出血量、症状改善、术后融合情况进行比较.结果前、后入路方式治疗胸腰椎结核在手术时间、出血量方面差异无统计学意义(P>0.05),三种手术入路手术治疗前后在症状改善、畸形矫正方面差异有统计学意义(P<0.05),三种手术入路治疗胸腰椎结核临床疗效差异无统计学意义(P>0.05).结论根据患者全身情况、病灶大小及破坏程度、脊柱畸形程度,正确选择手术入路及手术方式,可以取得胸腰椎结核良好的治疗效果.随着微创手术方式及设备的发展,结核前路手术可逐渐由开放手术向微创手术转变.Objective To explore the clinical effect of different surgical approaches for thoracolumbar spinal tuberculosis patients. Methods The clinical data of 137 patients with thoracolumbar spinal tuberculosis from January 2004 to January 2019 were reviewed retrospectively analyzed.The enrolled patients were divided into three groups based on different surgical methods:group A(n=59)were treated via anterior surgical approach,group B(n=40)were treated via posterior surgical approach,and group C(n=38)were combined anterior and posterior surgical approach.The data of operation time,intraoperative blood loss were compared between group A and group B.The clinical effectiveness was evaluated by using visual analogue scale(VAS),Cobb`s angle and bone fusion time between the 3 groups. Results All operations completed successfully,all patients improved significantly after surgery.The operation time and intraoperative blood loss was no statistically significance between A and B groups(P>0.05).The VAS and the Cobb`s angle were improved after operation between 3 group(P<0.05).The clinical effectiveness was no statistically significance between 3 groups(P>0.05). Conclusion Three differnt surgical approach are all safe and effective methods for thoracolumbar spinal tuberculosis pations.As long as the surgical indications are correct,it an effectively remove the lesion,reconstruct the stability of the spine,correct the deformity and achieve satisfactory outcome.

关 键 词：胸腰椎结核 前入路手术 后入路手术 

分 类 号：R68[医药卫生—骨科学]