摘要
目的分析单纯后路病灶清除内固定局部灌注化疗治疗胸腰椎结核的临床效果.方法选择云南省文山州中医医院2015年1月-2021年8月收治的胸腰椎结核病人52例作为研究对象,根据回顾性临床资料分析,将其分为两组,每组26例,对照组的病人采用前后联合入路病灶清除内固定治疗,观察组采用后路病灶清除内固定局部灌注化疗治疗.比较两组手术的操作所需时间、手术失血总量、术后窦道形成、术后复发、术后出院的时间、治疗前后病人血红蛋白、C反应蛋白、后凸Cobb角、视觉模拟评分、Frankel评分.结果观察组手术操作所需时间、手术失血总量、术后出院的时间少于对照组,治疗后病人血红蛋白、Frankel评分高于对照组,C反应蛋白、后凸Cobb角、视觉模拟评分低于对照组,P<0.05.观察组的术后窦道形成、术后复发例数少于对照组,组间有显著差异,P<0.05.结论后路病灶清除内固定局部灌注化疗治疗胸腰椎结核疗效确切,复发率低,可减少创伤和失血量,更好控制机体炎症,改善机体功能,单纯后路病灶清除植骨内固定治疗成人胸腰椎结核可在一次手术中同一切口内达到椎管内减压、脊柱矫形、脊柱植骨融合和脊柱恢复稳定的目的,清除双侧腰大肌脓肿无需行双侧切口,清除胸椎病灶能避免经胸手术带来的并发症,手术效果满意,是目前治疗脊柱结核较理想的治疗方法,值得推广.
Objective To analyze the clinical effect of single posterior debridement b,one grafting,internal fixation and local chemotherapy for the treatment of thoracolumbar spinal tuberculosis.Methods From January 2015 to August 2021,52 patients with thoraco-lumbar spinal tuberculosis of our hospital were operated,the patients were divided into two groups according to the retrospective analysis of clinical data,the patients in the control group were treated with anterior posterior combined approach focus removal and internal fixation,and the patients in the observation group were treated with potserior focus removal and internal fixation and local perfusionc hemotherapy.The operation time,total blood loss,postoperative sinus formation,postoperative recurrence,postoperative discharge time,hemoglobin,C-reactive protein,kyphosis Cobb angle,visual analog score and Frankel score were compared between the two groups.R esults The operation time,total blood loss and postoperative discharge mti e of the observation group were less than those of the control group.After treatment,the hemoglobin and Frankel scores of the patients were higher than those of the control group,and the C-reactive protein,kyphosis Cobb angle and visual analog scores were lower than those of the control group P(<0.05).The postoperative sinus formation and postoperative recurrence in the observation group were lower than those in the control group,and there was significant dffierence between the groups(P<0.05).Conclusion The curative effect of single posterior debridement,bone grafting,internal fixation and local chemotherapy for the treatment of thoracolumbar spinal tuberculosis is valid,the recurrence rate is low.It can reducet rauma and blood loss,better control body inflammation and improve body function.Single posterior debridement,bone grafting,internal fixation in the treatment of adult thoracolumbar tubercuol sis can achieve the purpose of intraspinal decompression,spinal correction,fusion and spinal stabilization in one operation.There is no need for bilateral incision to remove bilateral psoas abscess.Clearing thoracic lesions can avoid the complications of transthoracic surgery,and the operation effect is satisfactory.It is a satisafctory treatment method for spinal tuberculosis at present,which is worth popularizing.
作者
郭德斌
常正彪
何书平
杨弘炯
郭怀泽
刘德伟
Guo Debin;Chang Zhengbiao;He Shuping;Yang Hongjiong;Guo Huaize;Liu Dewei(Wenshan Traditional Chinese Medicine Hospital,Wenshan,Yunnan 663099,China)
出处
《首都食品与医药》
2023年第11期51-54,共4页
Capital Food Medicine
关键词
后路病灶清除内固定
局部灌注化疗治疗
胸腰椎结核
临床效果
Posterior debridement and internal fixation
Local perfusion chemotherapy
Thoracolumbar tuberculosis
Clinical effect
