经皮穿刺局部化疗治疗老年性脊柱结核

Treatment of spinal tuberculosis in old people with percutaneous puncture and local chemotherapy

[目的]研究CT引导下经皮穿刺局部化疗治疗老年性脊柱结核的疗效.[方法]23例60岁以上的老年性脊柱结核患者,19例行CT引导下经皮病灶清除局部化疗;4例行病灶切除,内固定治疗.[结果]所有患者平均卧床3～6个月,没有交叉感染、窦道形成和复发.21例患者恢复生活自理.1例Frankel D级局部化疗的患者1个月后发现症状和体征加重,改为手术治疗,术后瘫痪不全恢复.[结论]老年脊柱结核患者多数合并其他系统疾病,无法耐受切开手术.经皮穿刺局部化疗创伤小、花费少、疗效好,大多数患者可以恢复患病前的日常生活状态.

[ Objective] To investigate the result for treatment of spinal tuberculosis in old people with percutaneous puncture and local chemotherapy. [ Method] Among 23 patients, 19 patients were treated with percutaneous puncture and local chemotherapy, 4 recerved focus debriclement and internal fixation. [ Result] No patient required readmission to hospital for the reason of reactivation of the disease. No complication was found. Twenty-one patients returned to home environment and normal daily lives. Activities of 2 patients over 70 years were limited because of senility and other system diseases. Paralysis was found in 1 ease and debridement was received 1 month later. [ Conclusion] Percutaneous puncture and local chemotherapy has advantages such as： less postoperative immobilization; less operative clanger; less medical expenses. Most patients return to their normal daily lives. It is a recommendable method for the treating of spinal tuberculosis in old people.