27例外科治疗脊柱结核病例的长期随访与分析

Long-term follow-up and analysis of 27 cases of spinal TB after surgical treatment

目的:通过长期随访27例外科治疗脊柱结核病例,探讨外科方法对于脊柱结核的治疗效果。方法:回顾性分析本单位近10年来收治的采用病灶清除植骨内固定术治疗的27例脊柱结核病例,通过分析平均44个月的随访结果,评价外科手术和药物干预的治疗效果。结果:本组所有患者早期随访结果显示:伤口一期愈合,内固定稳定,脊髓压迫症状缓解或消失。长期随访结果显示:能够贯彻全程化疗方案的病例,植骨完全融合,脊髓症状无反复,结核病灶无复发;未能完成化疗方案的4例患者在切口部位出现窦道,并在植骨床周围形成死骨,感染复发。4例复发患者经全身使用抗结核药物和二次手术翻修,在完成12月术后化疗后治愈。结论:对于脊柱结核必需坚持外科手术与术后全程化疗并重的的治疗方法。

Objective： To evaluate the treating effects of surgery on the spinal tuberculosis of twenty-seven patients by long term fellow up.Method： Twenty-seven patients with spinal tuberculosis,admitted in our hospital in the past 10 years,were retrospectively an-alyzed.They were treated with focal clearance followed with boneautograft and internal fixation.After average period of 44 months,the treating effects ofsurgery andchemotherapy.Results： The results of short term follow-up showed that all the cuts were A healing and all the fixation were stable,the compression symptoms were relieve or vanish.But by the long term follow-up,patients whoobeyed to the entire chemotherapy gainedcompletely recovered fromspinal tuberculosis.Onthe contrary,4 patients who gave up the chemotherapy were foundrecrudescence of tuberculosis and retreated by surgery and entirechemotherapy.Conclusions： In the treatment of spinal tuberculosis,both surgery and entire chemotherapy should be emphasized.