脊柱结核有限性病灶清除术的临床研究

Spinal Tuberculosis Lesions Cleared Clinical Study

目的:研究采用有限结核病灶清除术治疗脊柱稳定性未完全破坏、无神经损害脊柱结核的效果。方法:2007年1月-2012年2月手术治疗脊柱稳定性尚未完全破坏、无神经损害脊柱结核患者86例,根据住院顺序随机分成两组:彻底病灶清除固定组44例,给予病灶彻底清除术+内固定术,有限清除组42例,给予结核病灶有限清除术。随访3个月～3年,比较两组患者术后效果、费用等情况。结果:全部患者手术切口都为一期愈合。两组术后效果比较差异无统计学意义(P>0.05)。与彻底病灶清除固定组比较,有限清除组手术时间显著缩短(P<0.05),出血量显著减少(P<0.05),脊柱畸形矫正度数小(P<0.01),治疗费用少(P<0.01)。结论:有限脊柱结核病灶清除术治疗无明显失稳及神经损害脊柱结核经济而有效。

Objective：To study the limited nature of tuberculosis to remove the effect of the stability of the spine surgery heal all damaged spinal tuberculosis.Method：Surgical treatment of spinal stability in January 2007 February 2012 is still not Completely destroyed in spinal tuberculosis, 86 cases, 56 cases of male and female 30 cases;age between 21 to 75 years old, average age 43.3 years;duration of 50 months, mean .disease duration was 18 months.According to the order in which the hospitalization were randomly divided into two groups：thoroughly remove fixed group of 44 treated lesions all cleared by surgery, clear group co.LTD of 42 cases of tuberculosis limited dissection.Follow-up three months to three years, were compared to the effect of postoperative complications and cost.Result：All patients had surgical incision for a healing.The effect of postoperative comparison, the difference was not statistically significant（P〉0.05）.Clear group co.LTD, surgery time and thoroughly remove fixed group significantly shortened（P〈0.05）;bleeding than thoroughly remove fixed group was significantly reduced（P〈0.05）;spinal deformity by correction angle than thoroughly remove fixed group is small （P〈0.01）;treatment costs ratio less in the control group（P〈0.01）.Conclusion：The limited nature of spinal tuberculosis Clear the treatment of spinal tuberculosis is an economical and effective treatment.