CAJ | 학술논문

目的：评价脊柱结核术后持续灌洗局部化疗闭式负压引流治疗的疗效。方法：选择需手术治疗的脊柱结核患者36例，所有患者在经全身化疗后，行脊柱后路手术，术中于原结核病灶部位放置灌注冲洗管，通过灌注冲洗维持局部化疗，同时放置引流管接负压机或中心负压在封闭状态下持续引流。结果：全组术中病灶清除及放置冲洗、引流管顺利，持续灌洗局部化疗时间明显延长，脱管、局部药物渗漏、结核复发情况显著减少。局部化疗时间(50±10)d，随访(16±8)个月，患者局部疼痛症状及病灶均消失，大部分生活自理，部分恢复体力劳动。结论：通过脊柱结核术后持续灌洗、闭式负压引流技术的改进，达到有效维持局部化疗的目的，并成功运用在脊柱结核合并严重畸形、神经功能障碍的病例中。
목적：평개척주결핵술후지속관세국부화료폐식부압인류치료적료효。방법：선택수수술치료적척주결핵환자36례，소유환자재경전신화료후，행척주후로수술，술중우원결핵병조부위방치관주충세관，통과관주충세유지국부화료，동시방치인류관접부압궤혹중심부압재봉폐상태하지속인류。결과：전조술중병조청제급방치충세、인류관순리，지속관세국부화료시간명현연장，탈관、국부약물삼루、결핵복발정황현저감소。국부화료시간(50±10)d，수방(16±8)개월，환자국부동통증상급병조균소실，대부분생활자리，부분회복체력노동。결론：통과척주결핵술후지속관세、폐식부압인류기술적개진，체도유효유지국부화료적목적，병성공운용재척주결핵합병엄중기형、신경공능장애적병례중。
Objective:To explore the curative effect of local chemotherapy and persistent lavage closed negative pressure drainage in the treatment of spinal tuberculosis.Methods:36 cases of spinal tuberculosis which need operation treatment were selected.All cases were given posterior spinal operation after chemotherapy.In the operation,we placed irrigation pipe on primary tuberculosis lesions to maintain local chemotherapy through irrigation.At the same time,we placed drainage tube for continuous drainage with negative press or central negative pressure in the closed state.Results:During the operation,debridement and irrigation,drainage tube placement were successful;ersistent lavage chemotherapy time was prolonged;removal of tube,local drug leakage and tuberculosis recurrence were significantly reduced.Local time of chemotherapy was (50 ± 10) days;follow-up time was (16 ± 8) months;local pain symptoms and lesions of patients were all disappeared;most of the patients can take care of themselves;some patients recovered physical labor.Conclusion:Through the improvement of persistent lavage after spinal tuberculosis operation and closed negative pressure drainage technology,the purpose of effectively maintaining local chemotherapy can be achieved,and it is successfully applied in spinal tuberculosis complicated with severe deformity and nerve dysfunction patients.