两种手术治疗胸椎结核临床分析

Effects comparison of anterior focus clearance with autograft bone fusion and internal fixation via thoracic for thoracic vertebra tuberculosis

目的:比较两种手术入路治疗胸椎结核的临床疗效。方法:将符合标准的124例胸椎结核患者随机分成观察组(65例)和对照组(59例),观察组行经胸膜外一期前路病灶清除植骨融合内固定术,对照组行经肋骨横突病灶清除植骨术。结果:随访12～24个月,观察组在手术时间、术中出血量、植骨融合时间和平均矫正角度等方面明显优于对照组(P<0.05);对有脊髓神经损害的患者,两种术式对其恢复情况无统计学意义(P>0.05);从治疗效果看,观察组总有效率为93.85%,对照组总有效率为83.05%,两组患者临床疗效差异有统计学意义(P<0.05)。结论:经胸膜外一期前路病灶清除植骨融合内固定术治疗胸椎结核具有手术视野清楚、病灶清除彻底、复发率低、住院时间相对较短等优点,是治疗胸椎结核较好的方法之一。

To compare the clinical effects of anterior focus clearance with autogratt bone fusion and internal fixation via thoracic for thoracic vertebra tuberculosis. Methods.A total of 124 eligible patients with thoracic vertebra tuberculosis were randomly divided into observation group （65 eases） and control group （59 cases）. The control group was treated with debridement and bone graft via rib and transverse approach, while the observation group was treated with anterior focus clearance with autograft bone fusion. Results. According to followup of 12-24 months, the observation groups showed significant better outcomes regarding to the operation time, intraoperative bleeding volume, bone graft fusion time and the average correction angle than the control group （P〈0. 05）. For patients with spinal nerve impairment of the two groups, no significant differences in outcomes were found （P〈0.05）. Total effective rate was 93.85% in the observation group, significant higher than 83.05% of the control group （P〈0.05）. Conclusions：Anterior focus clearance with autograft bone fusion is a superior treatment for thoracic tuberculosis considering its advantages of clear operation vision, complete clearance of lesions, low incidence of reoccurrence, short hospitalization time.