血小板源性生长因子联合同种异体骨移植治疗脊柱结核疗效观察  

Efficacy of platelet-derived growth factor combined with allograft bone transplantation in the treatment of spinal tuberculosis

作　　者：徐尚胜 顾焕花 谢伟 霍永超 王春伟 白生录 马淑萍 孙玉鑫 XU Shangsheng;GU Huanhua;XIE Wei;HUO Yongchao;WANG Chunwei;BAI Shenglu;MA Shuping;SUN Yuxin(Department of Orthopedics,the 4 th People′s Hospital of Qinghai Province,Xining 810000,Qinghai Province,China)

机构地区：[1]青海省第四人民医院骨科,青海西宁810000

出　　处：《新乡医学院学报》2024年第11期1048-1054,共7页Journal of Xinxiang Medical University

基　　金：青海省第四人民医院院内自主课题(编号:ynzz-2023-11)。

摘　　要：目的探讨血小板源性生长因子(PDGF)联合同种异体骨移植治疗脊柱结核的疗效及安全性。方法选择2018年8月至2023年8月青海省第四人民医院收治的177例腰椎结核患者为研究对象。根据移植骨来源将患者分为对照组(n=49)和观察组(n=128)。患者术前均进行至少2周的正规四联抗结核化学治疗。对照组患者给予PDGF联合自体骨移植,观察组患者给予PDGF联合同种异体骨移植。记录2组患者的手术时间、术中出血量、住院时间;比较2组患者术前及术后1、3、6个月的全血红细胞沉降率(ESR)、血清C-反应蛋白(CRP)水平;术前进行CT及核磁共振成像(MRI)检查,术后待骨融合完成后复查CT及MRI,比较术前与术后Cobb角变化;术前及术后1、3、6个月,采用视觉模拟评分法(VAS)评估腰椎区域的疼痛程度,比较2组患者术前、术后VAS评分,并比较2组男性患者术前、术后VAS评分以及2组女性患者术前、术后VAS评分。结果观察组与对照组患者手术时间、住院时间比较差异无统计学意义(P>0.05)。观察组患者术中出血量显著少于对照组(P<0.05)。观察组与对照组患者术前、术后Cobb角比较差异均无统计学意义(P>0.05)。2组患者术后Cobb角与术前比较均显著降低(P<0.05)。2组患者术前及术后1、3、6个月的VAS评分均依次降低,组内两两比较差异均有统计学意义(P<0.05)。2组男性患者术前及术后1、3、6个月的VAS评分均依次降低,组内两两比较差异均有统计学意义(P<0.05)。2组女性患者术前及术后1、3、6个月的VAS评分均依次降低,组内两两比较差异均有统计学意义(P<0.05)。术前及术后1、6个月时,观察组与对照组患者VAS评分比较差异无统计学意义(P>0.05);术后3个月,观察组患者VAS评分显著低于对照组(P<0.05)。观察组男性患者术前及术后1、6个月的VAS评分与对照组男性患者比较差异无统计学意义(P>0.05);观察组男性患者术后3个月�Objective To explore the efficacy and safety of platelet-derived growth factor(PDGF)combined with allograft bone transplantation in the treatment of spinal tuberculosis.Methods A total of 177 patients with lumbar tuberculosis admitted to the 4 th People′s Hospital of Qinghai Province from August 2018 to August 2023 were selected as the research subjects.Patients were divided into control group(n=49)and observation group(n=128)based on the source of the transplanted bone.All patients underwent at least 2 weeks of standard quadruple anti-tuberculosis chemotherapy before surgery.Patients in the control group received PDGF combined with autograft bone transplantation,while patients in the observation group received PDGF combined with allograft bone transplantation.The surgical duration,intraoperative blood loss,and length of hospital stay of patients in the two groups were recorded;the erythrocyte sedimentation rate(ESR)and serum C-reactive protein(CRP)levels of patients in the two groups were compared before surgery and at 1,3,6 months after surgery.Preoperative CT and magnetic resonance imaging(MRI)examinations were performed,and postoperative CT and MRI were performed after bone fusion was completed to compare the changes in Cobb angle before and after surgery.The visual analogue scale(VAS)was used to assess the pain degree in the lumbar region before surgery and at 1,3,6 months after surgery.The VAS scores of patients in the two groups,VAS scores of male patients in the two groups,and VAS scores of female patients in the two groups were compared before and after surgery,respectively.Results There was no statistically significant difference in surgical duration and length of hospital stay between the observation group and the control group(P>0.05).The intraoperative blood loss of patients in the observation group was significantly less than that in the control group(P<0.05).There was no statistically significant difference in Cobb angle before and after surgery between the two groups(P>0.05).The postoperative Co

关 键 词：脊柱结核 血小板源性生长因子 同种异体骨 自体骨 

分 类 号：R529.2[医药卫生—内科学]