脊柱结核患者接受后路椎弓根螺钉内固定联合前路病灶清除植骨融合术的效果  

Effect of Posterior Pedicle Screw Fixation Combined with Anterior Debridement Osteofusion in Patients with Spinal Tuberculosis

作　　者：徐林飞 沈皆亮[2] XU Linfei;SHEN Jieliang(Department of Orthopaedics,Henan Chest Hospital,Zhengzhou 450000,China;Department of Orthopedics,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]河南省胸科医院骨科,河南郑州450000 [2]重庆医科大学附属第一医院骨科,重庆400016

出　　处：《河南医学研究》2023年第16期2945-2948,共4页Henan Medical Research

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20210228)。

摘　　要：目的探讨脊柱结核患者接受后路椎弓根螺钉内固定联合前路病灶清除植骨融合术的效果。方法选取河南省胸科医院2021年1月至2022年1月收治的50例脊柱结核患者的临床资料,按随机数字表法分为对照组和观察组,各25例。对照组接受Ⅰ期前路病灶清除、植骨融合内固定术治疗,观察组接受后路椎弓根螺钉内固定联合前路病灶清除植骨融合术。比较两组患者围手术期指标、红细胞沉降率、C反应蛋白水平、Cobb角、骨融合率和复发率。结果观察组手术时间、住院时间短于对照组,术中出血量少于对照组(P<0.05);与手术前相比,手术后观察组红细胞沉降率、C反应蛋白、Cobb角均低于对照组(P<0.05);观察组骨融合率高于对照组,复发率低于对照组(P<0.05)。结论脊柱结核患者接受前后路联合手术可有效减少创伤,降低红细胞沉降率和复发率,疗效确切且安全性较高。Objective To investigate the effect of posterior pedicle screw fixation combined with anterior debridement osteofusion in patients with spinal tuberculosis.Methods Clinical data of 50 patients with spinal tuberculosis admitted to Henan Chest Hospital from January 2021 to January 2022 were selected and divided into control group and observation group according to random number table method,with 25 cases in each group.The control group received stageⅠanterior debridement and bone graft fusion,and the observation group received posterior pedicle screw internal fixation combined with anterior debridement and bone graft fusion.Perioperative indexes,erythrocyte sedimentation rate,C-reactive protein level,Cobb angle,bone fusion rate and recurrence rate were compared between the two groups.Results The operation time and hospital stay in the observation group were shorter than those in the control group,and the intraoperative blood loss was less than that in the control group(P<0.05).Compared with before operation,erythrocyte sedimentation rate,C-reactive protein and Cobb angle in observation group after operation were lower than those in control group(P<0.05).The bone fusion rate of observation group was higher than that of control group,and the recurrence rate was lower than that of control group(P<0.05).Conclusion Combined anterior and posterior approach can effectively reduce trauma,erythrocyte sedimentation rate and recurrence rate in patients with spinal tuberculosis,with accurate efficacy and high safety.

关 键 词：脊柱结核 病灶清除植骨融合术 椎弓根螺钉内固定术 红细胞沉降率 复发率 

分 类 号：R681.5[医药卫生—骨科学]