微创术与传统病灶清除术在脊柱结核治疗中的疗效对比  

Comparison of the efficacy of minimally invasive surgery and traditional debridement in the treatment of spinal tuberculosis

作　　者：陈品奇 杨杰 陈朝奎 何先游 高登宁 CHEN Pin-qi;YANG Jie;CHEN Chao-ku(Third Affiliated Hospital of Guizhou Medical University,Guizhou 558000,China)

机构地区：[1]贵州医科大学第三附属医院,558000

出　　处：《中国实用医药》2021年第20期66-69,共4页China Practical Medicine

摘　　要：目的对比微创术与传统病灶清除术在脊柱结核治疗中的临床效果。方法90例脊柱结核患者,随机分为微创组和清除组,各45例。微创组施行微创术治疗,清除组施行传统病灶清除术治疗。对比两组患者手术前后的Frankel分级及Cobb角,手术指标、并发症发生情况。结果手术前及手术后,两组患者的Frankel分级对比,差异均无统计学意义(P>0.05)。手术后,微创组患者的Cobb角为(10.2±4.9)°,大于清除组的(6.1±3.8)°,差异有统计学意义(P<0.05)。微创组患者的手术时间、术中出血量、椎体骨性融合时间分别为(1.1±0.4)h、(23.5±4.6)ml、(159.6±11.8)d,清除组患者的手术时间、术中出血量、椎体骨性融合时间分别为(3.0±1.6)h、(201.6±6.3)ml、(259.9±21.5)d。微创组患者的手术时间、椎体骨性融合时间短于清除组,术中出血量少于清除组,差异有统计学意义(P<0.05)。微创组患者的并发症发生率2.22%低于清除组的17.78%,差异有统计学意义(P<0.05)。结论脊柱结核的两种术式中,微创术在改善手术指标和并发症方面较为明显,传统病灶清除术在Cobb角方面改善更为显著,通常情况下建议选择微创治疗的方式。Objective To compare the clinical effect of minimally invasive surgery and traditional debridement in the treatment of spinal tuberculosis.Methods A total of 90 patients with spinal tuberculosis were randomly divided into minimally invasive group and debridement group,with 45 cases in each group.The minimally invasive group was treated with minimally invasive surgery,and the debridement group was treated with traditional debridement.The Frankel grading and Cobb angle before and after operation,operation indicators,and occurrence of complications were compared between the two groups.Results Before and after operation,there was no statistically significant difference in Frankel grading between the two groups(P>0.05).After operation,the Cobb angle of minimally invasive group was(10.2±4.9)°,which was greater than(6.1±3.8)°of debridement group,and the difference was statistically significant(P<0.05).The operation time,intraoperative blood loss and vertebral bone fusion time of minimally invasive group were(1.1±0.4)h,(23.5±4.6)ml and(159.6±11.8)d,which were(3.0±1.6)h,(201.6±6.3)ml and(259.9±21.5)d of debridement group,and the difference was statistically significant(P<0.05).The incidence of complications 2.22%of minimally invasive group was lower than 17.78%of debridement group,and the difference was statistically significant(P<0.05).Conclusion In the two procedures of spinal tuberculosis,minimally invasive surgery is more obvious in improving surgical indicators and complications.Traditional debridement has more significant improvement in Cobb angle.Generally,it is recommended to choose minimally invasive treatment.

关 键 词：微创术 传统病灶清除术 脊柱结核 Frankel分级评定 COBB角 

分 类 号：R687.3[医药卫生—骨科学]