侧前方入路与后方椎间孔入路在治疗下胸椎结核的效果及对并发症的影响  

Effect of Lateral Anterior Approach and Posterior Transforaminal Approach in the Treatment of Lower Thoracic Tuberculosis and Its Impact on Complications

作　　者：蒋雄健[1] 付朝华[1] JIANG Xiongjian;FU Chaohua(Jiangmen Central Hospital,Jiangmen 529030,China;不详)

机构地区：[1]广东省江门市中心医院,广东江门529030

出　　处：《中国医学创新》2020年第13期65-69,共5页Medical Innovation of China

摘　　要：目的:探究侧前方入路与后方椎间孔入路在治疗下胸椎结核的效果及对并发症的影响。方法:选取2013年2月-2018年12月本院脊柱骨科收治的下胸椎结核患者60例,依据手术入路方式不同分为两组,研究组40例,对照组20例。对照组采用侧前方入路方式,研究组采用后方椎间孔入路,观察两组手术前后脊椎损伤等级、Cobb角改善情况、临床疗效及术后并发症。结果:两组手术前Frankel分级比较,差异无统计学意义(P>0.05),研究组术后Frankel分级优于对照组(P<0.05);研究组手术后Cobb角小于对照组(P<0.05),研究组Cobb角改善率高于对照组(P<0.05)。研究组总有效率为100%,高于对照组的85.0%(P<0.05)。研究组并发症发生率为7.5%,与对照组的20.0%比较,差异无统计学意义(P>0.05)。结论:骨科下胸椎结核采用后方椎间孔入路的疗效确切,可显著降低并发症发生率,改善脊柱损伤情况,值得在临床中推广及深层次研究。Objective: To investigate the effect of lateral anterior approach and posterior transforaminal approach in the treatment of lower thoracic tuberculosis and its impact on complications. Method: From February 2013 to December 2018, 60 patients with lower thoracic tuberculosis admitted to the department of spinal orthopedics in our hospital were selected and divided into two groups according to different surgical approaches, 40 patients in the study group and 20 patients in the control group. The control group adopted the lateral anterior approach and the study group adopted the posterior transforaminal approach, the preoperative and postoperative spinal injury grade, Cobb Angle improvement, clinical efficacy and postoperative complications of two groups were observed. Result: There was no significant difference in Frankel grading between two groups before operation(P>0.05). The Frankel grading in the study group after operation was better than that in the control group(P<0.05). The Cobb angle in the study group after operation was less than that in the control group(P<0.05), the improvement rate of Cobb angle in the study group was higher than that in the control group(P<0.05). The total effective rate in the study group was 100%, which was higher than 85.0% in the control group(P<0.05). The incidence rate of complications in the study group was 7.5%, the control group was 20.0%, there was no significant difference between two groups(P>0.05). Conclusion: The curative effect of the posterior transforaminal approach of the lower thoracic tuberculosis is obvious, which can significantly reduce the incidence of complications and improve the spinal injury of patients. It is worthy of promotion and deep research in the clinic.

关 键 词：侧前方入路 后方椎间孔入路 下胸椎结核 并发症 

分 类 号：R687.3[医药卫生—骨科学]