中国医药指南
中國醫藥指南
중국의약지남
CHINA MEDICINE GUIDE
2015年
16期
25-27
,共3页
寸新华%郑刚%饶涛%窦吉辰%杨阳
吋新華%鄭剛%饒濤%竇吉辰%楊暘
촌신화%정강%요도%두길신%양양
结核%脊柱%病灶清除%内固定
結覈%脊柱%病竈清除%內固定
결핵%척주%병조청제%내고정
Tuberculosis%Spinal%Debridement%Internal ifxation
目的：根据脊柱稳定性的状况，探讨脊柱结核外科治疗的术式选择。方法总结回顾2006年8月至2013年12月手术治疗的脊柱结核患者共114例，所有病例分为A组（59例）一期单纯脊柱结核病灶清除治疗组，B组（55例）一期病灶清除、植骨融合并内固定治疗组。分别对比研究A及B手术时间、术中出血量、矫形率、神经功能恢复情况、植骨融合时间、并发症等。结果平均随访1年10个月，82例患者获访，两组患者脊柱结核均治愈，A组术后优良率84.5%，B组94.6%。有1例术后慢性窦道形成，其他患者切口愈合良好。53例有脊柱后凸畸形者，单纯病灶清除术病例中脊柱畸形无纠正，且一段时间后均有不同程度的矫正角度丢失。行病灶清除、植骨融合并内固定术病例中后凸畸形平均矫正25.8°，随访中平均丢失2.6°。37例有明显神经损害的患者手术后均获得改善。结论脊柱结核外科治疗可采用个体化治疗，在药物抗结核治疗的基础上，根据脊柱稳定性的不同选择合适的外科术式进行手术治疗，均可获得满意的临床疗效。
目的：根據脊柱穩定性的狀況，探討脊柱結覈外科治療的術式選擇。方法總結迴顧2006年8月至2013年12月手術治療的脊柱結覈患者共114例，所有病例分為A組（59例）一期單純脊柱結覈病竈清除治療組，B組（55例）一期病竈清除、植骨融閤併內固定治療組。分彆對比研究A及B手術時間、術中齣血量、矯形率、神經功能恢複情況、植骨融閤時間、併髮癥等。結果平均隨訪1年10箇月，82例患者穫訪，兩組患者脊柱結覈均治愈，A組術後優良率84.5%，B組94.6%。有1例術後慢性竇道形成，其他患者切口愈閤良好。53例有脊柱後凸畸形者，單純病竈清除術病例中脊柱畸形無糾正，且一段時間後均有不同程度的矯正角度丟失。行病竈清除、植骨融閤併內固定術病例中後凸畸形平均矯正25.8°，隨訪中平均丟失2.6°。37例有明顯神經損害的患者手術後均穫得改善。結論脊柱結覈外科治療可採用箇體化治療，在藥物抗結覈治療的基礎上，根據脊柱穩定性的不同選擇閤適的外科術式進行手術治療，均可穫得滿意的臨床療效。
목적：근거척주은정성적상황，탐토척주결핵외과치료적술식선택。방법총결회고2006년8월지2013년12월수술치료적척주결핵환자공114례，소유병례분위A조（59례）일기단순척주결핵병조청제치료조，B조（55례）일기병조청제、식골융합병내고정치료조。분별대비연구A급B수술시간、술중출혈량、교형솔、신경공능회복정황、식골융합시간、병발증등。결과평균수방1년10개월，82례환자획방，량조환자척주결핵균치유，A조술후우량솔84.5%，B조94.6%。유1례술후만성두도형성，기타환자절구유합량호。53례유척주후철기형자，단순병조청제술병례중척주기형무규정，차일단시간후균유불동정도적교정각도주실。행병조청제、식골융합병내고정술병례중후철기형평균교정25.8°，수방중평균주실2.6°。37례유명현신경손해적환자수술후균획득개선。결론척주결핵외과치료가채용개체화치료，재약물항결핵치료적기출상，근거척주은정성적불동선택합괄적외과술식진행수술치료，균가획득만의적림상료효。
Objective According to the state of spinal stability, to discuss surgical treatment of spinal tuberculosis in operation choice. Methods Summary review in August 2006 to December 2013, A total of 114 patients with surgical treatment of spinal tuberculosis, all cases were divided into group A (59 cases) issue of pure spinal tuberculosis kitchen removal treatment group, group B (55 cases) issue of lesion clearance and bone graft fusion and internal ifxation in treatment group. Comparative study A and B respectively operation time, intraoperative blood loss, rate of orthopaedic, neural function recovery, the bone graft fusion time, complications, etc. Results A mean follow-up of 1 year 10 months, 82 patients received visit, two groups of patients with spinal tuberculosis were cured, postoperative was 84.5%in group A and group B 94.6%. With chronic sinus tract, 1 case of postoperative patients with other incisions healed well. 53 cases with protruding after spinal deformity, simple removal of lesion cases no correct spinal deformity, and after a period of time all have different degrees of lost corrective Angle. Line cases of lesion clearance and bone graft fusion and internal ifxation of the protruding after deformity correction average 25.8°, follow-up on average lost 2.6°. 37 cases of patients with obvious nerve damage after the operation, also get improved. Conclusion Surgical treatment of spinal tuberculosis can adopt individualized treatment, on the basis of drug anti-tuberculosis treatment, according to the spinal stability change to choose the appropriate surgery operation, all can obtain satisfactory clinical effect.
