脊柱结核植骨融合时间与术后血沉多样性的相关分析

Correlation between postoperative erythrocyte sedimentation rate multiformity and bone graft fusion horary of spinal tuberculosis patients

背景与目的:临床实践中观察到脊柱结核患者行结核病灶清除、植骨、加或不加钢板内固定术后患者的血沉变化与植骨块骨性融合时间有一定的联系,分析脊柱结核患者术后血沉多样性和植骨融合时间的相关性。方法:检索Pubmed数据库和CNKI数据库1997-01/2007-12相关文章,以了解脊柱结核患者植骨块骨融合时间与血沉的关系。同时收集2007-01/2008-12右江民族医学院附属医院脊柱骨病外科收治的脊柱结核患者60例进行临床验证。患者男28例,女22例,年龄27～66岁,平均44岁,均行结核病灶清除、自体髂骨植骨、加或不加钢板内固定术,并经病理证实。患者术后1,7,14d晨间空腹血沉检查,按血沉平均值分4组:轻度增快、中度增快、高度增快组和极度增快组。术后12,16,24周行X射线或CT检查及复查血沉,记录植骨块骨性融合情况并记录融合时间,对4组脊柱结核患者术后血沉多样性和植骨块骨性融合时间进行差异性和相关性分析。结果:检索结果证明,血沉是非特异性指标,许多因素均可引起血沉升高。临床验证表明,脊柱结核患者轻度增快组16例,中度增快组20例,高度增快组13例,极度增快组11例;骨性愈合时间:≤12周8例,≤16周34例,≤24周18例。4组植骨块骨性融合时间差异性分析显示,χ2=10.814,P=0.013,Spearman相关分析显示相关系数为r=0.414,P=0.001。结论:术后血沉多样性与脊柱结核术后植骨块骨性融合时间呈正相关。

BACKGROUND AND OBJECTIVE： Clinical practice showed that there is a relationship between erythrocyte sedimentation rates （ESR） and time of bone graft fusion in spinal tuberculosis patients, who underwent thoracoscopic cleaning of focus, with or without bone grafting. Therefore, this paper aimed to analyze the correlation between and bone graft fusion horary of spinal tuberculosis patients. METHODS： An online search of PubMed and CNKI database was undertaken to identify articles regarding ESR and bone graft fusion horary of spinal tuberculosis patients between January 1997 and December 2007. Sixty cases with spinal tuberculosis admitted in the Department of Orthopaedics, the Affiliated Hospital of Youjiang Medical College for Nationalities from January 2007 to December 2008 was collected, including 28 male, 22 female, aged 27-66 years, with average 44 years old. The patients were underwent tuberculose focus ablate, autologous iliac bone graft, with or without plate internal fixation, and confirmed by pathology. 60 cases of patients were inspected with ESR at days 1, 7, 14 after operation and divided into mildly faster, moderately faster, high faster and extremely fast growing groups according to the average ESR levels. At days 1,7, 14 after operation, patients were inspected ESR and X-ray or CT examination, recorded bone graft blocks bony fusion and time of bone graft blocks bony fusion. The spinal tuberculosis ESR diversity and graft bone block fusion time were analyzed variability and correlation. RESULTS： ESR used as a nonspecific marker, which could be influenced by many factors. The clinical verification showed that there were 16 cases in the mildly faster group, 20 cases in the moderately faster group, 13 cases in the high faster group, and 11 cases in the extremely fast growing group. Time of bone healing： 8 cases ≤12 weeks, 34 cases ≤18 weeks, 18 cases ≤24 weeks. The bone graft healing time were analyzed of variability and showed, x2=10.814, P=0.013, Spearman correlation analysis showed a correlation coefficient t-=0.414, P = 0.001. CONCLUSION： There is a positive correlation between ESR multiformity and time of bone graft fusion in patients with spinal tuberculosis.