摘要
目的探讨有限性结核病灶清除术治疗脊柱稳定性未完全破坏的脊柱结核的疗效。方法 2005年1月至2009年12月手术治疗成人胸、腰椎脊柱稳定性未完全破坏的脊柱结核患者98例,男56例,女42例;年龄22～73岁,平均36.2岁;病史3～48个月,平均17个月。按入院顺序随机分为2组:对照组50例行彻底的病灶清除术,实验组48例行有限性结核病灶清除术。术后随访3个月至3年,对比2组患者手术后疗效、并发症和经济费用。结果所有患者术后切口均一期愈合,无局部窦道形成。2组术后疗效综合评判差异无统计学意义(P>0.05)。实验组手术时间明显较对照组缩短[(2.5±0.5)vs(3.5±0.5)h,P<0.01];出血量明显少于对照组[(350±48)vs(450±50)ml,P<0.01];脊柱畸形矫正角度小于对照组(17.8°±5.1°vs22.8°±6.3°,P<0.01);治疗费用低于对照组[(3.5±1.3)vs(6.5±2.2)万元,P<0.01]。结论有限性脊柱结核病灶清除术对于脊柱稳定性未完全破坏的患者,尤其是经济条件较差的患者不失为一种经济有效的治疗手段。
Objective To investigate the efficacy of limited eradicating of tuberculous focus for treating spinal tuberculosis without complete destruction of the spinal stability.Methods Ninety-eight patients （age 22-73 years,mean 36.2 years;56 males and 42 females） with spinal tuberculosis without complete destruction of the thoracic and lumbar spinal stability underwent surgical treatment from January 2005 to December 2009 were enrolled in this study.The medical history was 3-48 months （mean 17 months）.The patients randomly divided into two groups according to hospitalyzed order：the experimental group （48 cases） and the control group （50 cases）.The tuberculous lesions were completely cleared in the control group,and the limited resection of tuberculous lesions was taken in the experimental group.The followed up period post operation was 3 months to 3 years.The postoperative efficacy,complications and expenditure were compared in two groups.Results The incisions of the all patients were primary healing after the operation,and there were no cases of sinus tract formation.The comprehensive estimation of postoperative efficacy in two groups had no statistical significance （P0.05）. Compared with control group,the operative time shortened obviously 〔（2.5±0.5） vs （3.5±0.5）h,P0.01〕,blood loss markedly lowered 〔（350±48） vs （450±50）ml,P0.01〕,the rectificatus angle of the spinal deformity obviously decreased （17.8°±5.1° vs 22.8°±6.3°,P0.01） and expenditure obviously decreased 〔（3.5±1.3） vs （6.5±2.2）ten-thousand-Yuan,P0.01〕 in the experimental group.Conclusions Limited resection of tuberculous focus is an economical and effective therapeutic method for the patients whose spinal stability have been not completely destroyed,particularly for the patients with poor economical conditions.
出处
《中国临床研究》
CAS
2011年第1期21-23,共3页
Chinese Journal of Clinical Research
关键词
脊柱结核
有限性结核病灶清除术
脊柱稳定性
Spinal tuberculosis
Limited resection of tuberculous focus
Spinal stability
