脊柱结核67例治疗体会

67 cases of spinal tuberculosis treatment

目的:探讨脊柱结核患者的手术治疗效果。方法:回顾性分析67例脊柱结核患者的临床资料,对于9例脊柱稳定性无明显破坏的病例,采用单纯病灶清除术,对于21例脊柱稳定性部分破坏的病例,采用病灶清除并植骨融合术,对于37例脊柱稳定性显著破坏的病例,采用病灶清除、植骨融合并内固定术。结果:67例脊柱结核患者,经手术治疗,优46例,占68.66%;良19例,占28.36%;差2例,占2.99%。住院时间27～60d,平均37d,卧床时间60～343d,平均108d。随访最长7年最短1年半,2例复发。结论:脊柱结核的治疗既要全身支持、常规化疗,也要手术时充分清除病灶,尽可能恢复脊柱生理及其稳定性。

To investigate the surgical patients with spinal tuberculosis treatment. Methods： Retrospective analysis of 67 cases of spinal tuberculosis in patients with the clinical data of 9 cases of spinal stability for no apparent destruction of the cases, the use of a simple surgery to remove lesions, 21 cases of spinal stability for some cases of destruction, the use of debridement and fusion surgery, 37 cases of spinal stability for significant damage to the cases, the use of debridement, bone grafting and internal fixation. Results： 67 cases of spinal tuberculosis patients treated by surgery, 46 cases of excellent, accounting for 68.66%; 19 cases of benign, accounting for 28.36%; two cases of poor, accounting for 2.99%. Length of stay 27 - 60d, an average of 37d, bed time for 60 - 343d, an average of 108d. The longest follow-up of 7 years minimum 1 year and a half years, two cases of recurrence. Conclusion： The treatment of spinal tuberculosis it is necessary to support the body, conventional chemotherapy, surgery should be the full removal of lesions, as far as possible, and the stability of the restoration of the physiological spine.