摘要
目的:评价CT引导下经皮穿刺微创病灶清除后灌注冲洗局部化疗治疗脊柱结核脓肿的疗效。方法:31例脊柱结核并脓肿患者,其中7例为脊柱结核病灶清除术后复发者,单侧脓肿25例,双侧脓肿6例。7例有神经功能障碍,Frankel分级D级5例,C级2例。所有患者在全身化疗的同时,行CT引导下经皮穿刺微创病灶清除术,术后原结核病灶部位及脓肿部位放置灌注冲洗管进行灌注冲洗和持续局部化疗。结果:全组病灶清除及灌注冲洗管放置顺利,1例因冲洗管脱落改为开放手术治疗;交叉感染1例,经引流及应用敏感抗生素后治愈;1例治疗后1年复发椎弓根结核,给予局部清创,继续局部化疗3个月后痊愈。局部化疗时间53±23d,随访18±6个月,患者的疼痛和脓肿消失,恢复正常工作或生活。结论:经皮穿刺病灶清除灌注冲洗局部化疗治疗不合并严重畸形和严重神经功能障碍的脊柱结核脓肿效果较好。
Objective：To evaluate the efficiency of minimal invasive surgery under CT guided in the management of spinal tuberculous abscesses.Method：A retrospective analysis of 31 patients with spinal tuberculous abscesses treated by percutaneous drainage and local chemotherapy was made.All of the patients were confirmed imagiologically and pathologieally without severe kyphosis or paraplegia.Operation included local focus debridement,abscesses drainage and persistent local chemotherapy.Result：All of the cases were smooth during the operation and no complication happened.The duration of local chemotherapy lasted 53±23 days and systematic chemotherapy for 12±6 months.All the abscesses disappeared during follow-up.I case recurred after 1 year with vertebral arch tuberculosis and treated with local chemotherapy again.Average time keeping in bed was 3.1±1.9 months.Conclusion：Minimal invasive surgery could be used to manage spine tuberculosis without severe kypbosis or severe paraplegia.
出处
《中国脊柱脊髓杂志》
CAS
CSCD
2005年第9期528-530,共3页
Chinese Journal of Spine and Spinal Cord
关键词
脊柱结核
结核性脓肿
局部化疗
Spinal tuberculosis
Tuberculous abscess
Local chemotherapy
