摘要
目的:探讨前路病灶清除、植骨融合加后路内固定术治疗胸腰椎结核(TVT)患者疗效及对围术期指标和神经功能恢复的影响。方法:选取2019年1月~2021年12月在本院确诊的92例TVT患者,根据手术方式分为A组49例和B组43例。A组接受前路病灶清除、植骨融合加后路内固定手术治疗,B组接受后路病灶清除、植骨融合加内固定手术治疗。比较两组切口长度、手术时间、术中出血量、术后总引流量和住院时间等围术期指标;比较两组术前、术后6个月Cobb角和数字疼痛(NRS)评分、腰椎功能障碍指数(ODI)评分、红细胞沉降率(ESR)、血清C反应蛋白(CRP)水平和ASIA分级改善情况及并发症发生率。结果:A组患者术中出血量、术后引流量和住院时间均明显少于B组;术后6个月,A组患者Cobb角大于B组,NRS评分、ODI评分则显著低于B组;A组患者ESR、CRP水平明显低于B组;两组患者术后6个月ASIA分级均较术前改善至少1个等级;两组患者ASIA分级无统计学意义;两组患者并发症发生率无显著差异。结论:前路病灶清除、植骨融合加后路内固定术治疗TVT患者疗效确切,可有效改善围术期指标,促进神经功能恢复。
Objective To explore the curative effect of anterior debridement,bone graft fusion and posterior internal fixation on thoracolumbar vertebral tuberculosis (TVT) and their influences on perioperative indexes and recovery of nerve function.Methods A total of 92 patients with TVT confirmed in the hospital were enrolled between January 2019 and December 2021.According to different surgical methods,they were divided into group A (49 cases,anterior debridement,bone graft fusion and posterior internal fixation) and group B (43 cases,posterior debridement,bone graft fusion and internal fixation).The perioperative indexes (incision length,operation time,intraoperative blood loss,postoperative total drainage volume,hospitalization time),Cobb angle,scores of numerical rating scale (NRS) and Oswestry disability index (ODI),levels of erythrocyte sedimentation rate (ESR) and serum C-reactive protein (CRP) before and at 6 months after surgery,improvement of ASIA grading and incidence of complications were compared between the two groups.Results The intraoperative blood loss,postoperative drainage volume and hospitalization time in group A were significantly lower than those in group B.At 6 months after surgery,Cobb angle in group A was larger than that in group B,while NRS and ODI scores were significantly lower than those in group B.The levels of ESR and CRP in group A were significantly lower than those in group B.At 6 months after surgery,ASIA grading was increased by at least 1 level in both groups.There was no significant difference in ASIA grading between the two groups.The difference in incidence of complications between group A and group B was not statistically significant (18.37% vs 18.60%).Conclusion The curative effect of anterior debridement,bone graft fusion and posterior internal fixation is significant on TVT patients,which can effectively improve perioperative indexes and promote the recovery of nerve function.
作者
唐伟
马良
地里下提·阿不力孜
Tang Wei;Ma Liang;Di Lixia Ti abulizi(Department of Orthopaedics,the Eighth Affiliated Hospital of Xinjiang Medical University,Urumqi 830049 China)
出处
《湖南师范大学学报（医学版）》
2022年第4期50-54,共5页
Journal of Hunan Normal University(Medical Sciences)
基金
国家大学生创新创业训练计划项目(201910789015)。
关键词
前路病灶清除
植骨融合
后路内固定术
胸腰椎结核
围术期指标
神经功能
anterior debridement
bone graft fusion
posterior internal fixation
thoracolumbar vertebral tuberculosis
perioperative index
nerve function
