中国老年学杂志
中國老年學雜誌
중국노년학잡지
CHINESE JOURNAL OF GERONTOLOGY
2014年
15期
4127-4129
,共3页
胸椎结核%后路椎管减压%前路病灶清除%植骨融合%后路内固定
胸椎結覈%後路椎管減壓%前路病竈清除%植骨融閤%後路內固定
흉추결핵%후로추관감압%전로병조청제%식골융합%후로내고정
Thoracic spinal tuberculosis%Posterior spinal decompression%Anterior debridement%Fusion%Posterior fixation
目的：观察两种不同的手术方式治疗老年胸椎结核的疗效。方法选择67例老年胸椎结核患者，对比患者行I期后路椎管减压、病灶清除、植骨融合内固定术（A组，n＝34）及I期后路内固定再行Ⅱ期前路病灶清除、植骨融合术（B组，n＝33）的手术时间、术中出血量、住院时间、后凸角和术后Frankle分级等的变化。结果 A组平均手术时间比B组明显缩短〔（150±21）vs （210±29） min，P＜0.01〕；A组平均术中出血量显著少于B组〔（400.6±56.2） vs （510.5±71.6）ml，P＜0.01〕；A组平均住院时间比B组显著减少〔（20.2±2.8） vs （26.8±3.7）d，P＜0.05〕。各组后凸角度数术后均比术前明显下降（均P＜0.01），两组后凸角和术后Frankle分级等比较无统计学差异（ P＞0.05）。两组术后后突畸形矫正率及影像学未见明显异常。结论Ⅰ期后路病灶清除椎管减压椎间植骨融合内固定术治疗老年胸椎结核有确切疗效；与分期前后路术式相比，具有创伤小等优势，可作为老年胸椎结核的一种治疗选择。
目的：觀察兩種不同的手術方式治療老年胸椎結覈的療效。方法選擇67例老年胸椎結覈患者，對比患者行I期後路椎管減壓、病竈清除、植骨融閤內固定術（A組，n＝34）及I期後路內固定再行Ⅱ期前路病竈清除、植骨融閤術（B組，n＝33）的手術時間、術中齣血量、住院時間、後凸角和術後Frankle分級等的變化。結果 A組平均手術時間比B組明顯縮短〔（150±21）vs （210±29） min，P＜0.01〕；A組平均術中齣血量顯著少于B組〔（400.6±56.2） vs （510.5±71.6）ml，P＜0.01〕；A組平均住院時間比B組顯著減少〔（20.2±2.8） vs （26.8±3.7）d，P＜0.05〕。各組後凸角度數術後均比術前明顯下降（均P＜0.01），兩組後凸角和術後Frankle分級等比較無統計學差異（ P＞0.05）。兩組術後後突畸形矯正率及影像學未見明顯異常。結論Ⅰ期後路病竈清除椎管減壓椎間植骨融閤內固定術治療老年胸椎結覈有確切療效；與分期前後路術式相比，具有創傷小等優勢，可作為老年胸椎結覈的一種治療選擇。
목적：관찰량충불동적수술방식치료노년흉추결핵적료효。방법선택67례노년흉추결핵환자，대비환자행I기후로추관감압、병조청제、식골융합내고정술（A조，n＝34）급I기후로내고정재행Ⅱ기전로병조청제、식골융합술（B조，n＝33）적수술시간、술중출혈량、주원시간、후철각화술후Frankle분급등적변화。결과 A조평균수술시간비B조명현축단〔（150±21）vs （210±29） min，P＜0.01〕；A조평균술중출혈량현저소우B조〔（400.6±56.2） vs （510.5±71.6）ml，P＜0.01〕；A조평균주원시간비B조현저감소〔（20.2±2.8） vs （26.8±3.7）d，P＜0.05〕。각조후철각도수술후균비술전명현하강（균P＜0.01），량조후철각화술후Frankle분급등비교무통계학차이（ P＞0.05）。량조술후후돌기형교정솔급영상학미견명현이상。결론Ⅰ기후로병조청제추관감압추간식골융합내고정술치료노년흉추결핵유학절료효；여분기전후로술식상비，구유창상소등우세，가작위노년흉추결핵적일충치료선택。
Objective To comparatively observed the effects of two different surgical methods on elderly thoracic spinal tuberculosis ( TST) in order to make clear the better treatment of elderly TST patients .Methods 67 cases of elderly patients with thoracic tuberculosis , including 34 cases (group A) with the treatment of stage Ⅰ posterior decompression, debridement, bone graft fusion and internal fixation and 33 cases ( group B) with the treatment of stage Ⅰposterior internal fixation plus stage Ⅱprimary anterior debridement and bone graft fu-sion, were retrospectively analyzed .The levels of the changes in operative time , blood loss, hospital stay, and postoperative kyphosis angle Frankle gradies were evaluated and compared .Results The mean operative time of group A was significantly shorter than that in group B〔(150 ±21) vs (210 ±29)min, P<0.01〕.The average blood loss of group A was significantly less than that of group B 〔(400.6 ± 56.2) vs (510.5 ±71.6)ml, P<0.01〕;and the average length of hospital stay of group A was significantly shorter than that in group B〔(20.2 ±2.8) vs (26.8 ±3.7)d,P<0.05〕.The differences between the two groups of change in postoperative kyphosis Frankle grading were not statistically significant .The postoperative kyphosis correction rate and imaging of the two groups showed no statistical difference . Conclusions The treatment of stage Ⅰposterior spinal decompression debridement and interbody fusion and internal fixation for elderly tho -racic tuberculosis exacts effect .Compared with the treatment of stage Ⅰposterior internal fixation plus stage Ⅱprimary anterior debridement and bone graft fusion , the treatment of stage Ⅰposterior spinal decompression debridement and interbody fusion and internal fixation , with less trauma and some advantages , could be used as a treatment option for elderly patients with TST .
