经皮微创手术治疗腰椎结核的中远期疗效分析

Analysis of the Middle and Remote Effect of Percutaneous Minimally Invasive Surgery for the Treatment of Lumbar Tuberculosis

目的探讨经皮微创手术治疗腰椎结核的中远期疗效。方法方便选择2013年2月—2014年7月在该院收治的80例腰椎结核患者为研究对象,随机分为对照组和观察组,每组40例。对照组采用单纯药物局部注射治疗,观察组采用微创病灶清除+置管引流+药物局部注射治疗。比较两组腰椎结核治疗3年优良率;治疗前、治疗后1周、随访3年Cobb角;干预前后患者血沉、腰椎功能障碍指数、疼痛程度。结果观察组腰椎结核治疗3年优良率为80.00%,高于对照组(χ2=8.538,P<0.05),且经治疗后1周、随访3年Cobb角分别为(23.92±0.25)、(15.14±0.62)°,优于对照组(t=4.251、5.731,P<0.05);经干预后,观察组血沉、腰椎功能障碍指数、疼痛程度分别为(7.71±0.32)mm/L、(13.01±7.34)、(1.12±0.74),均优于对照组,差异有统计学意义(t=15.623、9.126、4.023,P<0.05)。结论经皮微创手术治疗腰椎结核的中远期疗效确切,可有效改善血沉、腰椎功能,恢复Cobb角,减轻疼痛,值得推广和应用。

Objective This paper tries to analyze the long-term effect of percutaneous minimally invasive surgery for the treatment of lumbar tuberculosis.Methods 80 cases of lumbar tuberculosis in this hospital from February 2013 to July 2014 were convenient selected and divided into control group and observation group randomly,with 40 cases in each group.The control group was treated with local injection of pure drugs,and the observation group was treated with minimally invasive removal of focus removal combined with catheter drainage plus local injection of drugs.The excellent and good rate of lumbar tuberculosis treatment for 3 years was compared between the two groups.The Cobb angle before treatment,1 weeks after treatment,and 3 years follow-up period were observed,and the erythrocyte sedimentation rate,lumbar dysfunction index and pain degree before and after intervention were compared.Results The observation group of lumbar tuberculosis treatment was 80.00%higher than that of the control group 3 years of excellent rate(χ2=8.538,P<0.05),and after 1 weeks after treatment,follow-up of 3 years Cobb angle respectively(23.92±0.25),(15.14±0.62)°,better than the control group(t=4.251,5.731,P<0.05);by doing the prognosis of the observation group,ESR,lumbar dysfunction index,the degree of pain were(7.71±0.32)mm/L,(13.01±7.34),(1.12±0.74)were better than the control group,the difference was statistically significant(t=15.623,9.126,4.023,P<0.05).Conclusion Percutaneous minimally invasive surgery for lumbar tuberculosis is effective in the long term.It can effectively improve ESR,lumbar function,restore Cobb angle and relieve pain,and is worthy of popularization and application.