手术治疗梅毒性脊髓炎临床病例特征分析  

A clinical case analysis on the characteristics of the surgical treatment of syphilitic myelitis

作　　者：公绪强 矫健航[1] 王洋 张翰 吴敏飞 GONG Xuqiang;JIAO Jianhang;WANG Yang;ZHANG Han;WU Mingfei(The Second Hospital of Jilin University,Changchun 130041,China)

机构地区：[1]吉林大学第二医院,长春130041

出　　处：《长春中医药大学学报》2021年第4期848-850,共3页Journal of Changchun University of Chinese Medicine

基　　金：吉林省自然科学基金(20200201448JC);吉林省医疗卫生人才专项项目(2019SCZT031)。

摘　　要：目的探讨梅毒性脊髓炎患者的诊疗过程,通过1例病例的回顾,学习文献,分析梅毒性脊髓炎患者的流行病学特点、影像学特征、组织病理学特征、鉴别诊断与治疗方法及预后等。方法1位52岁女性患者因双下肢麻木无力10 d入院,接受胸椎管内病损切除术+椎弓根钉内固定术+胸椎植骨术治疗,术后2周内连续予青霉素320万U及甲泼尼龙80 mg治疗。结果术后患者症状明显减轻,复查梅毒抗体指标下降,随访10个月后,患者运动感觉正常。结论梅毒性脊髓炎较为少见,需早期识别及明确诊断,全身性的抗梅毒治疗及手术清除病灶对于患者的预后极为重要。Objective To analyze the epidemiological characteristics,imaging features,histopathological characteristics,differential diagnosis,treatment methods,prognosis,and so on,and to ultimately explore the diagnosis and treatment process of patients with syphilitic myelitis.Methods A 52-year-old female patient was admitted to our hospital due to the numbness and weakness of both lower limbs for 10 days,and received the thoracic spinal lesion resection+pedicle screw internal fixation+thoracic spine bone grafting.Within 2 weeks after the operation,she was continuously treated with penicillin 3.2 million U and methylprednylone 80 mg.Results The symptoms of the patient were significantly reduced after the surgery,and the indexes of the syphilis antibody were decreased.After 10 months of follow-up,the patient felt normal in her motor sense.Conclusion Syphilitic myelitis is a rare disease and needs early identification and correct diagnosis.A systemic anti-syphilitic treatment and surgical removal of the lesions are very important for the prognosis of patients.

关 键 词：梅毒性脊髓炎 病损切除 病理特征 

分 类 号：R687.3[医药卫生—骨科学]