CT引导经皮微创技术与开放手术治疗脊柱结核的疗效分析

Clinical results of percutaneous intubation irrigation under CT guidance versus traditional open surgery in spinal tuberculosis

[目的]回顾性分析CT引导下经皮微创技术与传统开放手术治疗脊柱结核的临床效果。[方法]1998年5月～2009年5月,采用经皮微创技术与传统开放手术治疗脊柱结核68例。分别记录两组手术时间、术中出血量、住院时间、单病种总医疗费用。术后采用Oswestry功能障碍指数评分及治疗前后后凸角改变进行疗效评估。[结果]两组手术时间、术中出血量、住院时间、单病种总医疗费用比较差异均有统计学意义(P<0.01)。两组Oswestry功能障碍指数,治疗前后后凸角比较差异有统计学意义(P<0.01)。[结论]CT引导下经皮微创技术与传统开放手术疗效相近,且克服了传统手术存在的缺陷,具有操作简便、安全、手术时间短、出血少、治疗费用低等优点,是理想的微创手术方法。

[Objective]To investigate clinical outcomes of percutaneous intubation irrigation under CT guidance versus traditional open surgery for spinal tuberculosis. [Methods]The sample included 65 patients who underwent the minimally invasive versus the traditional open surgery.All medical and surgical records were examined and analyzed,including length of surgery,intraoperative blood loss,postsurgery hospital stay and total medical cost of single disease.Therapeutic effect was assessed by Oswestry functional disability index and the changes of convex during follow-up period. [Results]The operation time,bleeding amount,length of hospital stay and total medical cost of single disease were significantly different between two groups（P〈0.01）.Oswestry functional disability index and convex changes before and after surgery were significantly different between two groups（P〈0.01）. [Conclusion]Two methods have the similar therapeutic effect,but percutaneous intubation irrigation under CT guidance eliminates the shortcoming of traditional open surgery,and has merits of simple technique,security,shorter operative time,less blood loss and lower medical cost.It is one of ideal minimally invasive surgery for spinal tuberculosis.