脊柱结核的个体化手术治疗疗效研究  

Study on the Curative Effect of Individualized Surgical Treatment for Spinal Tuberculosis

作　　者：张超[1] 周迎锋[1] 赵红星[1] 耿晓林[1] 陶金刚[1] 徐海斌[1] ZHANG Chao;ZHOU Ying-feng;ZHAO Hong-xing;GENG Xiao-lin;TAO Jin-gang;XU Hai-bin(Department of Orthopeadic Surgery,the First Affiliated Hospital of Xinxiang Medical University,Xinxiang 453100,Henan Province,China)

机构地区：[1]新乡医学院第一附属医院骨外科,河南卫辉453100

出　　处：《罕少疾病杂志》2021年第2期88-90,共3页Journal of Rare and Uncommon Diseases

摘　　要：目的研究脊柱结核个体化手术方式及其治疗效果。方法以我院2016年1月至2018年12月收治的80例脊柱结核患者为研究对象,根据不同入路方式将其分为前路组、后路组与前后路联合组,比较三组手术时间、术中出血量、手术后凸畸形矫正角度、椎体高度重建、手术前后ESR(血沉)及CRP(C反应蛋白)指标。结果前路组手术时间(97.2±25.4)min,显著短于后路组[(126.8±55.7)min]、前后路联合组[(146.9±52.5)min,P<0.05];前路组椎体高度重建(23.5±12.8)%,显著高于后路组[(14.5±12.0)%]、前后路联合组[(13.0±12.2)%,P<0.05];三组后凸畸形矫正角度比较差异无统计学意义(P>0.05);三组术后1个月ESR、CRP水平较术前均明显下降(P<0.05)。结论前路手术时间短、椎体高度重建效果明确,后路手术术中出血量少,前后路联合手术清除结核杆菌感染效果明显,且手术时间长,临床建议根据患者情况制定个体化治疗方案。Objective To study the individualized surgical method and its therapeutic effect for spinal tuberculosis.Methods 80 cases of patients with spinal tuberculosis admitted into the hospital from January 2016 to December 2018 were taken as the research object and were divided into the anterior group,posterior group and anterior and posterior joint group according to the different approaches.The operation time,volume of intraoperative bleeding,the corrective angle of postoperative kyphosis,vertebral body height reconstruction,ESR(erythrocyte sedimentation rate)and CRP(C-reactive protein)indexes before and after the operation were compared among the three groups.Results The operative time of the anterior group was(97.2±25.4)min which was significantly shorter than(126.8±55.7)min of the posterior group and(146.9±52.5)min of the anterior and posterior joint group(P<0.05);There were(23.5±12.8)%of vertebral body height reconstruction in the anterior group which was significantly higher than(14.5±12.0)%in the posterior group and(13.0±12.2)%in the anterior and posterior joint group(P<0.05);The contrast difference in the corrective angle of postoperative kyphosis among the three groups was of no statistical significance(P>0.05);A month after the operation,levels of ESR and CRP in the three groups significantly decreased,compared with those before operation(P<0.05).Conclusion The time of anterior operation is short,and the effect of vertebral body height reconstruction is clear.The volume of intraoperative bleeding of posterior surgery is less.The effect of anterior and posterior combined surgery for clearance of Mycobacterium tuberculosis infection is obvious with long operation time.In the clinic,it is recommended that an individualized treatment plan should be made according to the conditions of patients.

关 键 词：脊柱结核 个体化手术 不同入路方式 

分 类 号：R529.2[医药卫生—内科学]