结核病灶清除术联合植骨融合外固定术治疗膝关节结核的疗效分析

Efficacy of tubercular focus debridement combined with fusion with bone graft and external fixation for treating tuberculosis of knee joint

目的观察结核病灶清除术联合植骨融合外固定术治疗膝关节结核的临床效果。方法膝关节结核患者102例采用随机数字表法分成A组和B组,每组51例。A组施行膝关节结核病灶清除术治疗,B组施行膝关节结核病灶清除术联合植骨融合外固定术治疗,对比两组患者术后并发症、复发率、关节功能改善情况及生活质量改善情况。结果 B组患者术后低蛋白血症及贫血发生率均高于A组(P<0.05);两组患者术后复发率比较无统计学意义(P>0.05);两组患者术后的关节功能及生活质量评分均高于术前,而B组患者术后关节功能评分及生活质量评分均低于A组(P<0.05)。结论结核病灶清除术联合植骨融合外固定术及单纯结核病灶清除术治疗膝关节结核均能改善患者术后关节功能以及生活质量,但病灶清除术联合植骨融合外固定术术后并发症发生率高且降低患者的生活质量改善程度。

Obje ctive To investigate the clinical efficacy of tubercular focus debridement combined with fusion with bone graft and external fixation for treating tuberculosis of knee joint .Methods A total of 102 patients with tuberculosis of knee joint were randomly divided into group A or group B ,with 51 cases in each group .Tubercular focus debridement of knee joint was performed in group A ,while tubercular focus debridement of knee joint combined with fusion with bone graft and external fixation was performed in group B .The postoperative complications ,recurrence rate , improvements of joint function , and quality of life were compared between the two groups . Results The incident rates of postoperative hypoproteinemia and anemia in group B were higher than those in group A （P〈0.05）.There was no statistical difference in the postoperative recurrence rate between the two groups （ P〉0.05 ） .In both groups ,the postoperative scores of joint function and the quality of life after treatment were higher compared to those before treatment .The postoperative scores of joint function and the quality of life were lower in the group B compared to the group A （ P〈0.05 ） .Conclusion Either tubercular focus debridement alone or its combination with tubercular focus debridement can improve postoperative joint function and the quality of life in the patients with tuberculosis of knee joint .Howevert,ubercular focus debridement combined with fusion with bone graft and external fixation obtains a higher incident rate of postoperative complications and less improvement in the quality of life of patients .