侧前方入路单侧钉棒固定治疗胸椎结核32例  

32 Cases of Study for Thoracic Tuberculosis with Unilateral Screws Rod Fixation by Anterolateral Approach

作　　者：卞恒杰 周宇 王睿[1] 任国飞[1] 李同林[1] 陆万里 王中兴 孔晓海[1] BIAN Hengjie;ZHOU Yu;WANG Rui;REN Guofei;LI Tonglin;LU Wanli;WANG Zhongxing;KONG Xiaohai(Department of Orthopedics,Nanjing Integrated Traditional Chinese and Western Medicine Hospital,Nanjing University of Traditional Chinese Medicine,Nanjing 210014,China.)

机构地区：[1]南京中医药大学附属南京市中西医结合医院骨一科,南京210014

出　　处：《中国中医骨伤科杂志》2021年第6期66-70,共5页Chinese Journal of Traditional Medical Traumatology & Orthopedics

摘　　要：目的:回顾分析侧前方入路病灶清除自体髂骨植骨单侧钉棒固定治疗胸椎结核的相关病例,总结影响治疗效果的相关因素,为胸椎结核的合理化治疗提供参考。方法:搜集2017年7月至2020年6月行侧前方入路病灶清除自体髂骨植骨单侧钉棒固定治疗的胸椎结核病例32例,统计患者年龄、性别、病损节段数、手术前后抗结核时长、手术时长、术中出血量、术后引流量、术后下地时间、融合例数及复发例数。分析胸椎结核发病与年龄、性别的关系,胸椎结核的好发节段,该治疗方法的治愈率,不同因素对患者术后下地时间的影响。结果:胸椎结核好发于活动度相对较大的T4~L1,其中T10~L1椎间隙较多,涉及1个间隙的25例,涉及2个间隙的7例,男女比例为1∶1.3。平均年龄为(47.74±5.37)岁,术前平均抗结核时长为(16.25±3.14)d,手术时长为(142.51±21.42)min,术中出血量为(619.25±56.32)mL,术后引流量为(316.74±35.93)mL,术后抗结核时长为(14.48±3.58)个月,术后下地时间为(37.32±6.87)d。术后脓肿复发2例,经病灶清除+VSD负压吸引后痊愈,术后骨融合率为100%。结论:胸椎结核多发于活动度较大的底胸椎,中老年多见,侧前方入路病灶清除自体髂骨植骨单侧钉棒固定疗效确切,患者年龄小的、病损节段少的、术前得到充分抗结核准备的、手术时长短的、术中出血及术后引流量少的患者术后恢复较快。Objective:A retrospective analysis was made on the related factors of the treatment of thoracic tuberculosis by debridement,autogenous iliac bone graft and unilateral internal fixation in the anterolateral approach of authors’department.The related factors influencing the therapeutic efficacy were summarized so as to provide references for the rational treatment of thoracic tuberculosis.Methods:From July 2017 to June 2020,32 cases of thoracic spinal tuberculosis were collected.The age,gender,number of lesion segments,duration of anti-tuberculosis before and after operation,duration of operation,amount of intraoperative blood loss,postoperative drainage,postoperative landing time,number of fusion cases and recurrence cases were statistically analyzed.The relationship between the incidence of thoracic tuberculosis and age,gender,the predilection segment of thoracic tuberculosis,the cure rate of this treatment method,and the influence of different factors on the postoperative time of patients were analyzed.Results:Thoracic tuberculosis occurred in the relatively large possibility on the thoracic 4-lumbar 1,and the thoracic 10-lumbar 1 intervertebral was the most common.Among these cases pathology involved one segments in 25 cases and,two segments in 7 cases.The ratio of male to female was 1∶1.3.The average age was(47.74±5.37)years old.The average preoperative anti-tuberculosis time was(16.25±3.14)d.The operation time was(142.51±21.42)min.The intraoperative blood loss was(619.25±56.32)mL,and the postoperative drainage volume was(316.74±35.93)mL.The postoperative anti-tuberculosis time was(14.48±3.58)months,and the postoperative landing time was(37.32±6.87)d.Postoperative recurrence of abscess in 2 cases were cured by debridement and VSD negative pressure suction.Postoperative fusion rate was 100%.Conclusion:Thoracic tuberculosis mostly occurs in the lower thoracic vertebrae with obvious range of motion,which is more common in middle-aged and elderly people.The curative efficacy of unilateral screw rod fixa

关 键 词：侧前方入路病灶清除 胸椎结核 自体髂骨植骨 单侧钉棒固定 

分 类 号：R529.2[医药卫生—内科学]