微创手术与传统开放手术治疗脊柱结核的疗效对比分析

Efficacy Comparative Analysis of Minimally Invasive Surgery and Traditional Open Surgery in the Treatment of Spinal Tuberculosis

目的:对比微创手术与传统开放手术治疗脊柱结核的疗效,总结脊柱结核手术管理经验。方法:2015年1月-2016年4月采用开放手术治疗126例患者入选开放组,采用微创手术治疗194例患者纳入微创组,比较两组各观察指标的差异。结果:末次随访,微创组与开放组后凸Cobb角、ESR、CRP水平均低于治疗前(P<0.05),开放组ESR低于微创组(P<0.05);开放组Frankel分级下降率100%(64/64),微创组100%(91/91),差异无统计学意义(P>0.05),开放组神经功能缺损痊愈率93.75%(60/64),微创组87.91%(80/91),差异无统计学意义(P>0.05);微创组手术时间、出血量、卧床住院时间、住院时间、切口感染、并发症发生合计例次率均低于开放组,差异均有统计学意义(P<0.05)。结论:微创手术具有明显的微创效果,康复速度快,但可能在改善血沉方面无明显优势,可能与其病灶清除效果有关。

Objective： To compare the effect of minimally invasive surgery and traditional open surgery in the treatment of spinal tuberculosis patients and to summarize the management experience of surgical treatment of spinal tuberculosis.Method： From January 2015 to April 2016, 126 patients treated with open surgery were selected as open group, 194 patients treated with minimally invasive surgery were selected as minimally invasive group, the effects of two groups were compared.Result： At the end of the follow-up, Cobb angle, ESR, CRP level of two groups were lower than those of before treatment, ESR of open group was lower than that of minimally invasive group, the differences were statistically significant （P〈0.05） .Frankel grade reduction rate of open group was 100% （ 64/64 ）, minimally invasive group was 100% （ 91/91 ）, there was no statistically significant difference （P〉0.05 ）, nerve function defect recovery rate of open group was 93.75% （ 60/64 ）, minimally invasive group was 87.91% （ 80/91 ）, there was no significant difference （P〉0.05） .Surgery time, bleeding volume, bed time, hospitalization time, incision infection, complications of total cases rate of minimally invasive group were lower than those of open group, the differences were statistically significant （ P〈0.05 ） .Conclusion： Minimally invasive surgery has obvious minimally invasive effect, fast recovery, but it may have no obvious advantage in improving erythroeyte sedimentation rate.