胸腰椎结核32例临床诊治

Diagnosis and treatment of thoracolumbar tuberculosis in 32 cases

目的探讨胸腰椎结核患者有效的临床诊断、围手术期处理、抗痨治疗、术式选择和手术方法。方法回顾性总结分析2001年1月至2007年12月本院收治的32例胸腰椎结核患者的临床资料。结果全组病例诊断明确,术前抗痨基础上均予以手术治疗;术后平均随访时间2年,影像学检查显示病灶愈合,恢复良好,植骨融合时间平均5.2个月,2例因植骨块轻度移位经卧床休息3个月,带支具活动6个月后治愈。结论早期的准确诊断,完善的围手术期处理,规范的药物化疗,恰当的手术时机和适宜的手术方式是提高胸腰椎结核治愈率、减少并发症和降低病残率的关键。

Objective To explore the diagnosis, perioperative period,chemotherapy and operation of thoracolumbar tuberculosis. Methods The clinical data of 32 thoracotumbar tuberculosis patients from Jan. 2001 to Dec. 2007 were retrospectively analyzed. Re- suits All patients were diagnosed correctly and treated by chemotherapy in perioprative period and operation,Follow--up after op- eration, all patients were healed, the incisions healed primarily without sinus formation. The graft fused in average 5.2 months. There was only 2 cases with slightly migration of bone graft material average,and after clinotherapy for 3 months and move with support for 6 months, they were also healed. Conclusion Early diagnosis, treatment in perioperative period, standard chemothera- py, proper operative opportunity and right operation type are most important for improving the recovery rate and decreasing compli- cations and disability rate in thoracolumbar tuberculosis.