32例布鲁杆菌性脊柱炎的临床分析

Clinical analysis of 32 cases with brucellosis spondylitis

目的加强对布鲁杆菌性脊柱炎临床特点的认识,减少误诊、误治的发生。方法选取本院2014年1月至2015年1月收治的32例布鲁杆菌性脊柱炎患者的临床资料进行回顾性分析与总结。结果32例患者均有不同程度的脊柱受累表现,且均以腰痛为主,少数可同时累及2~3个椎体。MRI影像特点为:受累椎体正常结构消失,骨质破坏,椎体边缘骨质增生明显,21例病例形成骨桥,14例病例椎体旁可见脓肿形成,但均无死骨,并可见椎间盘膨出及脊髓压迫等表现。确诊的32例布鲁杆菌性脊柱炎的患者按照规范的疗程,给予有效的抗菌药物联合抗菌治疗,均取得了显著的疗效。结论由于布鲁杆菌病临床表现复杂多样,临床症状多不典型,布鲁杆菌性脊柱炎常被误诊、误治,因此加强对布鲁杆菌性脊柱炎临床特点的认知非常重要。

Objective To investigate the clinical characteristics of brucellar spondylitis, and to reduce the misdiagnosis and mistreatment. Methods The clinical data of 32 cases with brucellar spondylitis in our hospital from January 2014 to January 2015 were analyzed, retrospectively. Results Total of 32 cases with varying degrees of spinal involvement, were mainly in low back pain, only a small number could be involved in 2-3 vertebral body. MRI features: the normal structure disappeared, vertebral body bone destruction, vertebral bone hyperplasia, 21 cases with bone bridge formation, 14 cases with paravertebral abscess visible, but no dead bone, and visible disc bulging and spinal cord compression performance. A total of 32 cases with brucellosis spondylitis, in accordance with the standard treatment course, effective combination of antibiotic treatment, had achieved remarkable curative effect. Conclusions The clinical manifestation of brucellosis was complicated, always with antypical clinical symptoms, so brucellar spondylitis was often misdiagnosed and mistreated, therefore it was very important to strengthen the understanding of the clinical features of brucellosis spondylitis.