摘要
[目的]探讨影响脊柱结核术后超短程化疗方案的因素。[方法]回顾性分析2004年1月~2013年12月在宁夏医科大学总医院脊柱骨科行手术治疗的211例脊柱结核患者。其中术后超短程化疗患者120例,非超短程化疗患者91例。应用Logistic回归分析比较两组患者的初治或复治年龄、术前是否合并其他疾病、是否合并其他部位活动性结核、是否贫血、病变累及节段、是否合并脓肿、手术分期、植骨材料、病灶彻底清除情况、植骨方式、耐药情况等与超短程化疗方案的相关强度,推测可能影响影响脊柱结核术后超短程化疗方案的因素。[结果]对可能的因素进行单因素Logistic回归分析示:病灶彻底清除、植骨方式、累及节段与脊柱结核术后超短程化疗方案有显著相关性(P<0.05)。多因素Logistic回归分析示:优势比数值大小排列为:病灶彻底清除(116.091)、植骨方式(5.252)、累及节段(0.241)。病灶彻底清除、支撑植骨是超短程化疗方案的有利因素,病变累及多节段是超短程化疗方案的不利因素。[结论]病变累及多节段属于不可控因素,病灶彻底清除、支撑植骨属于可控因素。在控制可控因素基础之上,可以实现超短程化疗方案。
[Objective] To explore the factors impacting the ultra-short-course chemotherapy of spinal tuberculosis after operation. [Methods] From January 2004 to December 2013, 211 patients with spinal tuberculosis were surgically treated in De- partment of Spinal Surgery, General Hospital of Ningxia Medical University. Of them, 120 patients got the ultra-short-course chemotherapy, whereas the remaining 91 patients received the non-short-course chemotherapy. A logistic regression analysis was conducted to compare the relative intensity of the variables between the two groups, including therapy for primary or recur- rent lesion, age, with or without accompanied diseases before operation, with or without active tuberculosis in other sites, ane- mia, segment involved, abscess, surgical staging, material of graft used, extent of debridement, bone grafting approach, extent of drug resistance and so on, to probe the factors that might affect the outcome of the ultra-short-course chemotherapy. [Results] The one-way logistic regression analysis revealed that significant correlations between the ultra-short course chemotherapy and the factors, including the extent of debridement, bone grafting approach and segment involved （P〈0.05）. In addition, the multi- variate logistic regression analysis showed that the odds ratio （OR） ranked as the following order： the extent of debridement （116.091） , bone grafting approach （5.252）, and segment involved （0.241） . It implied that the radical debridement and strut bone grafting would be the favorable factors for the ultra-short course chemotherapy, while the more segments involved would be an unfavorable factor for the ultra-short course chemotherapy. [Conclusion] For the ultra-short-course chemotherapy of spi-nal tuberculosis, the segments involved by the lesions should be uncontrollable factors, whereas the extent of debridement and whether or not strut bone grafting should be controllable factors. Properly handling the controllable factors, the ultra- short-course ch
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2018年第2期144-149,共6页
Orthopedic Journal of China
基金
国家自然科学基金项目(编号:81460336)
宁夏回族自治区重点研发计划项目(编号:2016-25)
关键词
超短程化疗
脊柱结核
病灶彻底清除术
支撑植骨
ultra-short-course chemotherapy, spinaltuberculosis, radical debridement, strut bone grafting
