80岁以上老年脊柱结核手术治疗和保守治疗的近期临床效果观察

Observation of the clinical results of surgical treatment and conservative treatment of spinal tuberculosis patients over 80 years old

目的探讨80岁以上高龄脊柱结核患者的临床特点,手术治疗的必要性及可行性,以提高病员生存质量。方法通过对2011~2012年本院80岁以上老年脊柱结核患者中,采取手术治疗(A组,n=9例)与保守治疗(B组,n=13例)患者的临床资料及结果进行对比分析。观察两组不同时间点的VAS评分、治疗前后脊髓神经功能分级(ASIA分级)及治疗后恢复速度(治疗1个月下床活动人数;治疗3个月下床活动人数;治疗3个月后血沉正常人数;治疗3个月后CRP正常人数)。结果术中及在院期间无严重并发症及死亡发生。手术治疗组的VAS评分、脊髓神经功能分级及恢复速度均优于对照组。结论在完善的围手术期管理及合理的术式选择情况下,大于80岁的高龄脊柱结核患者仍然可以选择手术治疗,能有效的提高病员的生存质量及满意率。

Objective Explore the necessity and feasibility and clinical features of surgical treatment of spinal tuberculosis patients over 80 years old,in order to improve patient's quality of life.Methods 22 cases of spinal tuberculosis patients aged over 80 years in Mianyang central hospital from January 2011 to October 2012 were comparative analyzed.All cases were divided into surgical treatment group(group A,n=9)and the conservative treatment group(group B,n=13).Pain scores(VAS) of the two groups at different time points,neural function classification(ASIA) and recovery rate were observed.Results No serious complications and deaths occurred during the hospital.VAS,neural function classification(ASIA) and recovery rate of the surgical treatment group are better than the control group.Conclusion In the perfect perioperative management and reasonable choice of surgical cases,Spinal tuberculosis patients more than 80 years old can still choice surgery,which can effectively improve the quality of life and rate of patient's satisfaction.