3种入路手术治疗胸椎结核的疗效

The effect of three kinds of approaches surgery for thoracic tuberculosis

目的回顾性分析前后路联合手术以及前路、后路手术治疗胸椎结核的疗效。方法84例胸椎结核患者(病灶≤2个节段),根据手术入路的不同分为A组(前路手术)、B组(后路手术)和C组(前后路联合手术),每组28例。比较3组患者的手术时间、术中出血量、红细胞沉降率(ESR)、C-反应蛋白(CRP)水平、Cobb角情况以及术后并发症。结果84例患者均随访1年。手术时间、术中出血量C组明显短(少)于A组和B组(P<0.05)。术后3个月及末次随访时ESR、CRP、Cobb角3组均明显低于术前(P<0.05),C组均明显低于A组和B组(P<0.05)。3组术后并发症发生率比较差异无统计学意义(P>0.05)。结论3种入路手术治疗胸椎结核均取得较好疗效。相较于前路、后路手术治疗,前后路联合手术治疗的临床效果更为满意。

Objective To retrospectively analyze the effect of anterior approach,posterior approach surgery,anterior and posterior combined approaches surgery for thoracic tuberculosis.Methods The 84 patients with thoracic tuberculosis(sick lesions≤2 segments),according to the different surgical approaches,they were divided into group A(anterior approach surgery),group B(posterior approach surgery)and group C(anterior and posterior combined approaches surgery).Each group had 28 cases.The operation time,intraoperative blood loss volume,erythrocyte sedimentation rate(ESR),C-reactive protein(CRP)levels,Cobb angle correction situation and postoperative complications were compared among the three groups.Results The 84 patients were followed up for 1 year.The operation time and intraoperative blood loss volume in group C were significantly shorter(less)than those in group A and group B(P<0.05).At 3 months postoperation and last follow-up,the ESR,CRP levels and Cobb angles in the three groups were all significantly lower than the preoperation(P<0.05),and which in the group C were significantly lower than those in the group A and the group B(P<0.05).There was no significant difference in postoperative complications incidence rate among the three groups(P>0.05).Conclusions Three approaches have achieved good results in the treatment of single-segment thoracic tuberculosis.Compared with anterior approaches and posterior approach,the clinical effect of anterior and posterior combined approaches surgery are more satisfactory.