微创手术在脊柱结核患者中的应用价值

The Applicative Value of Minimally Invasive Surgery in Spinal Tuberculosis Patients

目的探讨微创手术在脊柱结核患者中的应用价值。方法选取2012年1月至2015年4月重庆市大足区人民医院与重庆医科大学附属第一医院接诊的脊柱结核患者140例。按照随机数字表法分为观察组和对照组,各70例。观察组采用微创手术治疗;对照组采用传统开放手术治疗。比较两组患者的红细胞沉降率、术中出血量、手术时间、化疗药物使用时间、抗生素使用时间、住院时间、满意率以及治愈率。结果治疗后,两组患者的红细胞沉降率均有所下降,两组组间、组间·不同时点间交互作用比较差异无统计学意义(P>0.05);观察组术中出血量明显低于对照组[(23±4)m L比(197±6)m L],手术时间、化疗药物使用时间、抗生素使用时间、住院时间均短于对照组[(87±9)min比(171±11)min,(2.3±0.4)d比(39.4±6.5)d,(5.3±1.1)d比(7.9±1.2)d,(31.1±2.1)d比(64.6±3.5)d],差异有统计学意义(P<0.01);观察组的治愈率为97.14%(68/70),显著高于对照组的85.71%(60/70),差异有统计学意义(P<0.05);观察组的总满意率显著高于对照组[95.71%(67/70)比72.86%(51/70)],差异有统计学意义(P<0.05)。结论微创手术在脊柱结核患者中的应用价值良好,值得临床推广。

Objective To evaluate the applicative value of minimally invasive surgery in spinal tubercu- losis patients. Methods Total of 140 patients with spinal tuberculosis in Chongqing Dazu District People＇s Hospital and The First Affiliated Hospital of Chongqing Medical University from Jan. 2012 to Apr. 2015 were selected and divided into an observation group and a control group according to the random number table anethod,70 patients each. The observation group was treated with minimally invasive surgery;the control group was treated with traditional open surgery. The ESR values, intraopertive blood loss, operative time, chemotherapy usage time,antibiotic usage time, hospital stay, satisfaction rate and cure of the two groups were compared. Results After treatment,the erythrecyte sedimentation rates of both groups have declined, there was no significant difference between two groups, group, differen times （P 〉 0. 05 ）. The intracperative blood loss of the observation group was significantly lower than the control group[ （23 ±4） mL vs （197 ±6） mL, P 〈 0. 01 ] ;the operative time, chemotherapy time, antibiotic use time,hospitalization time of the observation group were shorter than the control group[（87 ±9） minvs （171 ±11） min,（2.3 ±0.4） d vs （39.4± 6. 5） d,（5.3 ±1.1） d vs （7.9 ±1.2） d,（31.1 ±2. 1） d vs （64.6±3.5） d] ,with statistically signifi- cant differences （ P 〈 0. 01 ） ; the cure rate of the observation group was 97. 14% （ 68/70 ）, significantly higher than the control group＇s 85.71% （ 60/70 ） （ P 〈 0. 05 ） ; the total satisfaction rate of the observation group was significantly higher than the control group[ 95.71% （67/70） vs 72. 86% （51/70） ,P 〈0. 05]. Conclusion The minimally invasive surgery has good applicative value for the spinal tuberculosis patients, thus is worthy of promotion in clinical.