保守方法治疗儿童轻度脊柱结核的疗效分析及预后随访

The effect analysis and follow-up of conservative treatment for mild spinal tuberculosis in children

目的探讨保守方法治疗儿童轻度脊柱结核的治疗效果及预后。方法 收集32例应用保守方法治疗的儿童轻度脊柱结核患者并随访3～5年,回顾性分析其病程变化、治愈时间、治愈率及脊柱后凸角的变化。结果31例（96.9%）患儿通过保守治疗获得治愈,其中11例（34.4%）患儿经过4～6个月的治疗获得治愈,13例（40.6%）患儿经过7～9个月的治疗获得治愈,7例（21.8%）患儿经过10～18个月的治疗获得治愈。6例（18.8%）患儿出现不同程度药物副作用。30例患儿应用保守治疗获得治愈并完成随访3～5年,与初诊时相比,9例（30.0%）患儿末次随访脊柱后凸角轻度增大,1例（3.3%）患儿末次随访脊柱后凸角增大17°,6例（20.0%）患儿末次随访脊柱后凸角减小,其余（46.7%）患儿末次随访脊柱后凸角大小均未见明显改变。患儿治疗前后脊柱后凸角比较差异无统计学意义。2例（6.3%）患儿随访2年后复发,其余患儿随访期内未见脊柱结核复发。结论 保守治疗对儿童轻度脊柱结核有较好的治疗效果及预后,医生应根据不同患儿的情况予个体化治疗。

Objective To evaluate the effect and prognosis of conservative treatment for mild spinal tuberculosis in children. Methods A total of 32 cases children suffering from mild spinal tuberculosis were collected, who were treated by conservative treatment and follow-up for 3-5 years. The progress of disease, the time of cure, the cure rate and the change of kyphosis angle were retrospectively reviewed. Results 31 cases （96.9%） got healed by conservative treatment. 11 cases（34.4%） healed after 4-6 months course of treatment. 13 cases（40.6%） children healed after 7-9 months course of treatment. 7 cases （21.8%） children healed after 10-18 months course of treatment. Various degree of drug side effects occurred in 6 cases（18.8%）. 30 cases got healed by conservative treatment and were followed up by totally 3- 5 years. Compared with the initially visit to hospital, the kyphosis angle mildly increased in 9 cases （30.0%） and obvi- ously increased in 1 cases （3.3%）.While the kyphosis angle decreased in 6 cases（20.0%） and no significant changes oc- curred in other cases. There was no statistical difference of kyphosis angle between before and after therapy. Only 2 cases （6.3%） had recurrence of spinal tuberculosis at the second years of follow-up and the other cases had no recur- rence during the time of followup. Conclusion The conservative treatment has good therapeutic？effects and prognosis for children who suffer from mild spinal tuberculosis.Doctor should give personalized therapy according to the situation of different children.