高龄胸椎结核运用前路和后路手术治疗的临床对比

Clinical Comparison of Anterior and Posterior Surgical Treatment for Elderly Tuberculosis of Thoracic Tuberculosis

目的探讨高龄胸椎结核运用前路和后路手术治疗的临床对比。方法方便选择2016年1月—2018年1月高龄胸椎结核患者45例,据术式分组。对照组22例开展前路手术治疗,观察组23例行后路手术治疗。比较两组高龄胸椎结核治疗效果;手术耗时、切口、出血、住院耗时;手术后患者生存质量QOL评分、神经功能等级的改善幅度;气胸、肺部感染、伤口延迟愈合等的发生率情况。结果观察组高龄胸椎结核治疗效果100.00%高于对照组72.73%(χ~2=6.033,P<0.05)。手术后观察组生存质量QOL评分、神经功能等级改善幅度(45.13±5.24)分、(2.02±0.21)级大于对照组(30.11±2.21)分、(1.01±0.22)级(t=5.822、6.012,P<0.05)。观察组住院耗时(13.14±0.24)d短于对照组(21.14±2.24)d,(t=8.012,P<0.05)。观察组气胸、肺部感染、伤口延迟愈合等的发生率少于对照组(χ~2=7.033,P<0.05)。结论高龄胸椎结核患者行后路手术疗效肯定,效果优于前路手术,可更好减少并发症,恢复神经功能和改善生活质量,可早期出院。

Objective To explore the clinical comparison of anterior and posterior surgical treatment for tuberculosis of the elderly.Methods 45 patients with thoracic spinal tuberculosis from January 2016 to January 2018 were selected conveniently according to surgical method.22 patients in the control group underwent anterior surgery and 23 patients in the observation group underwent posterior surgery.Compare the treatment effects of two groups of old age thoracic tuberculosis;time-consuming operation,incision,hemorrhage,and hospitalization time;QOL score of quality of life of patients after surgery;improvement degree of neurological function;incidence rate of pneumothorax,lung infection,delayed wound healing,etc.Results The treatment effect of tuberculosis tuberculosis in the observation group was 100.00%higher than that in the control group 72.73%,(χ2=6.033,P<0.05).After surgery,QOL scores of the quality of life of the observation group and the degree of improvement of the neurological function grade were(45.13±5.24)points and(2.02±0.21)grades were greater than the control group(30.11±2.21)points and(1.01±0.22)grades,(t=5.822,6.012,P<0.05).The hospitalization time of the observation group was(13.14±0.24)days shorter than that of the control group(21.14±2.24)days,(t=8.012,P<0.05).The incidence of pneumothorax,lung infection,delayed wound healing in the observation group was less than the control group(χ2=7.033,P<0.05).Conclusion The efficacy of posterior approach for tuberculosis in elderly patients with thoracic vertebral tuberculosis is affirmative.The effect is better than that of the anterior approach.It can reduce complications,restore nerve function and improve the quality of life,and can be discharged early.